title: Breast sculpturing: overcoming the limits of traditional approaches in breast reduction.
abstract: BACKGROUND
  A technique based on original refinements of the vertical breast reduction was developed in our department. The aim of the technique was the safe and aggressive sculpture of an attractive breast mound with minimal scarring and long-lasting results that is easy to perform and suitable for teaching purposes in a surgical training unit.
  
  
  METHODS
  Fifty consecutive patients who were to undergo bilateral breast reduction were prospectively enrolled in the study. Accurate standard anthropometric measurements and photographs were taken preoperatively and postoperatively at 2, 6, 12, 24, and 36 months. A selective breast liposuction plus a superior pedicle breast reduction with a vertical scar skin pattern was performed in all cases.
  
  
  RESULTS
  Nipple lifting ranged from 5 to 14 cm; reduction of the distance between the inframammary fold and the nipple ranged from 0.5 to 7 cm; breast base width reduction ranged from 0 to 7 cm.
  
  
  CONCLUSIONS
  This technique further contributes to vertical mammaplasty refinements, enhancing the key role of selective liposuction prior to surgical dissection of the breast. The basic principle is to convert a large breast into a middle-sized one, making vertical scar breast reduction the most appropriate technique for all cases. A thorough and selective liposuction of the breast mound reduces the breast cone base width safely and with virtually no limitations, thus breaking a taboo of traditional breast reduction techniques.
authors.affiliation: Department of Plastic and Reconstructive Surgery, University of Pavia, Salvatore Maugeri Foundation Hospital, Via Salvatore Maugeri 10, 27100 Pavia, Italy. giovanni.nicoletti@fsm.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Nicoletti
authors.forename: Silvia
authors.initials: S
authors.lastname: Scevola
authors.forename: Angela
authors.initials: A
authors.lastname: Faga
mesh_terms: D001940:Breast / Q000601:surgery*; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000601:surgery; D015187:Lipectomy; D016462:Mammaplasty / Q000379:methods*