title: [Criss-cross dermis suspension in the treatment of breast hypertrophy].
abstract: OBJECTIVE
  The results obtained with a technique using the dermis suspension associated with a central pedicled dermo-glandular-adipose flap, for the durable filling of the superior pole over time, are presented.
  
  
  METHODS
  Forty patients, affected by marked mammary hypertrophy, have been selected and divided into 2 groups (A, B) of 20 patients each. In both groups we have used a reduction mammaplasty technique based on a superior-medial dermo-glandular flap associated with a central pedicled dermo-glandular-adipose flap. In group B we have associated the preparation of the dermal brassiere crossed as a bra (criss-cross). In the follow-up of 15 months in average (range 8-24), we evaluated: the sensitiveness of the nipple-areola complex (NAC) using a visual analogic scale; the degree of mammary ptosis measuring the distance of the NAC from the jugulum and the distance between the areola and the submammary fold; the persistence of the filling of the superior pole, initially emptied, and the length of the scars.
  
  
  RESULTS
  The sensitiveness of the NAC in both groups was satisfactory in 72% (29/40) of the cases (P<0.001). The filling of the superior pole by a central pedicled dermo-glandular-adipose flap was satisfactory in both groups in the initial phase. The comparison between the 2 groups of patients showed, in the follow-up of 24 months, an areolar ptosis of 1.5 cm inferior in average (1 cm group A against 2.5 cm group B in average) and a marked decrease of the ptosis of the lower pole (P<0.001).
  
  
  CONCLUSIONS
  In the patients of group B the preparation of the dermal brassiere (criss-cross) led to an improvement of the stabilization of the form over time and a considerable decrease of the postoperative ptosis.
authors.affiliation: Unità di Chirurgia Plastica e Ricostruttiva, Seconda Università degli studi di Napoli, Naples. sergiobrongo@libero.it
authors.forename: S
authors.initials: S
authors.lastname: Brongo
authors.forename: R
authors.initials: R
authors.lastname: Grella
authors.forename: L S
authors.initials: LS
authors.lastname: Moccia
authors.forename: A
authors.initials: A
authors.lastname: D'Ari
authors.forename: F
authors.initials: F
authors.lastname: D'Andrea
mesh_terms: D000328:Adult; D001940:Breast / Q000473:pathology* / Q000601:surgery*; D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000601:surgery; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged