Craniomedial pedicled mammaplasty based on Würinger's horizontal septum.
BACKGROUND
During 30 months, 40 "septum-based" mammaplasties with a craniomedial pedicle were performed. This report aims to demonstrate the anatomic basics of the horizontal septum and the authors' experience with the septum-based mammaplasty technique.


METHODS
A series of 40 consecutive patients underwent a "septum-based" mammaplasty. This technique uses a medial pedicle based on Würinger;s horizontal septum, which is the main plain for the neural and vascular supply of the nipple-areolar complex (NAC).


RESULTS
The mean nipple-to-sternal-notch distance was 32 cm (range, 24-43 cm). The mean resection weight was 648 g (range, 484-1,320 g), and the mean nipple elevation was 9.5 cm (range, 5-18 cm). There were no hematomas and no partial or complete NAC necroses. Minimal wound dehiscence at the T-junction was present in three cases (7.5%). The pre- and postoperative NAC sensibilities were comparable in all the patients.


CONCLUSIONS
Based on Würinger;s horizontal septum, a safe and well-vascularized mammaplasty is possible even with large resection weights and long nipple-areola distances, and NAC sensibility can be preserved. The reported technique combining excellent pedicle perfusion with a wide variety of breast shaping proved to be safe.
Department of Hand, Plastic and Reconstructive Surgery and Intensive Burn Care Unit, BG-Trauma Center Ludwigshafen, Ludwig Guttmann Strasse 13, Ludwigshafen, Germany. hryssel@bgu-ludwigshafen.de
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Ryssel
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Germann
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Reichenberger
D000328:Adult; D001940:Breast / Q000033:anatomy & histology / Q000098:blood supply; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D009558:Nipples / Q000098:blood supply / Q000294:innervation