title: The vertical reduction mammaplasty: a prospective analysis of patient outcomes.
abstract: BACKGROUND
  In the United States, breast reductions based upon a Wise pattern incision remain common. However, dissatisfaction with this procedure, on the part of the patient and the surgeon alike because of unsightly scars and long-term "bottoming out" of the breast, has promoted the search for alternative methods of breast reduction. The purpose of this study was to analyze patient outcomes after vertical reduction mammaplasty utilizing prospectively collected data.
  
  
  METHODS
  All patients were given a custom-designed questionnaire designed to evaluate their macromastia-related symptoms and other macromastia-related quality-of-life issues. Patients were then provided the same questionnaire at their final postoperative visit between 3 and 6 months after surgery.
  
  
  RESULTS
  A total of 63 patients underwent vertical reduction mammaplasty and 40 patients underwent Wise pattern inferior pedicle reduction mammaplasty. Vertical reduction mammaplasty resulted in significant decreases in all macromastia-related symptoms analyzed, including upper back pain, lower back pain, neck pain, arm pain, shoulder pain, hand pain, breast pain, headaches, rashes and/or itching, and painful brassiere strap grooving (all, p < 0.00001). Furthermore, vertical reduction mammaplasty resulted in significant improvement in all quality-of-life factors analyzed, including difficulty buying clothes and brassieres, difficulty playing sports, and difficulty running (all, p < 0.00001). Minor complications (superficial infection, seroma, or delayed wound healing) occurred in 16 patients (25 percent) in the vertical reduction mammaplasty group. Minor office revisions (scar revision or excision) were performed in four patients (6 percent) in the vertical reduction mammaplasty group.
  
  
  CONCLUSIONS
  The authors' method of vertical reduction mammaplasty offers substantial relief of macromastia-associated symptoms with a low complication/revision rate.
authors.affiliation: Institute of Reconstructive and Plastic Surgery, Division of Plastic Surgery, New York University School of Medicine, New York, NY, USA.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Spector
authors.forename: Rebecca
authors.initials: R
authors.lastname: Kleinerman
authors.forename: Alfred T
authors.initials: AT
authors.lastname: Culliford
authors.forename: Nolan S
authors.initials: NS
authors.lastname: Karp
mesh_terms: D000328:Adult; D001416:Back Pain / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D013536:Suture Techniques; D016896:Treatment Outcome