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Reduction Mammaplasty in Adolescents: A Comparison of Wise and Vertical Incision Patterns
Egro FM, Kulkarni K, Haywiser C, Kenny EM, Stavros AG, Grunwaldt LJ
Department of Plastic Surgery, University of Pittsburgh School of Medicine, 3550 Terrace Street, 6B
2018-01-31
Presenter: Kritika Kulkarni
Affidavit:
Vu T. Nguyen
Director Name: Vu T. Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background: Reduction mammaplasty ameliorates many of the physical and psychological problems associated with adolescent macromastia, and is frequently accomplished by the use of either a Wise or vertical incision pattern. The aim of this study is to compare the outcomes of these two techniques in adolescents undergoing reduction mammaplasty.
Methods: A retrospective study of adolescents undergoing breast reduction by a single surgeon between 2011-2017 was conducted. Wise and vertical reduction techniques were compared based on demographics, clinical outcomes including surgical complications, patient satisfaction, and aesthetic outcomes. Patient satisfaction was determined using the validated BREAST-Q survey, and aesthetic outcomes using the validated ABNSW system.
Results: A total of 60 adolescent patients underwent reduction mammaplasty (Wise/inferior pedicle=81.7%, vertical/superior medial pedicle=18.3%). Patients who were overweight (Wise=38.8%, vertical=72.7%, p=0.041), and reported preoperative shoulder grooving (Wise=20.4%, vertical=54.5%, p=0.021) or asymmetry (Wise=10.2%, vertical=36.4%, p=0.028) were more likely to undergo a vertical pattern. Patients who reported preoperative pain (Wise=95.9%, vertical=72.7%, p=0.012) were more likely to undergo Wise pattern reduction. Patients with Wise pattern reduction had a greater number of preoperative macromastia diagnoses (Wise=95.9%, vertical=63.6%, p=0.001), and more bilateral reductions (Wise=93.9%, vertical=63.6%, p=0.04). The overall major and minor complication rates were 1.7% (Wise=2.0%, vertical=0%, p=NS) and 23.3% (Wise=20.4%, vertical=36.4%, p=NS), respectively. Aesthetic outcomes and patient satisfaction were comparable in both groups.
Conclusions: Reduction mammaplasty is a safe and effective treatment for adolescent macromastia. The similarity in complication rates between Wise and vertical reduction patterns suggests that both techniques can be safely performed in the adolescent population.
