title: Inferiorly based parenchymal flap mammaplasty:  a safe, reliable, and versatile technique for breast reduction and mastopexy.
abstract: BACKGROUND
  Breast reduction and mastopexy are among the most frequent procedures in aesthetic breast surgery. Many approaches have been described, and various types of dermaglandular pedicles for the nipple-areola complex have been used. The authors present a technique suitable for either mastopexy or breast reduction whereby the superior or superomedial pedicle supplying the nipple-areola complex is combined with an inferior dermaglandular flap to restore the upper pole fullness, thereby improving breast shape and projection.
  
  
  METHODS
  From January of 2008 to January of 2010, 83 patients underwent inferiorly based parenchymal flap mammaplasty. Patients' ages ranged from 23 to 65 years. The mean follow-up period was 27 months. The inferior breast tissue that is usually removed in a superior/superomedial pedicle technique is spared and shaped as a small implant and stitched to the pectoralis major muscle. The superior/superomedial pedicle is used for the nipple-areola complex.
  
  
  RESULTS
  All the procedures were successful. No major complications were reported. All the patients were very satisfied with the shape, size, projection, and upper pole fullness of their breast postoperatively as reported by the questionnaire. Comparative evaluation test scores of a four-member jury were significantly higher regarding breast shape (p = 0.007), projection (p = 0.0041), and upper pole fullness (p = 0.0028).
  
  
  CONCLUSIONS
  The inferiorly based parenchymal flap mammaplasty is a safe, versatile, and reproducible technique. It demonstrates ease of pedicle shaping and breast remodeling in patients undergoing mastopexy and breast reduction.
  
  
  METHODS
  Therapeutic, IV.
authors: Milan, Italy From the Department of Plastic Reconstructive Surgery and Burn Unit, Ospedale Niguarda Ca' Granda.
authors: Stefano
authors: S
authors: Bonomi
authors: André
authors: A
authors: Salval
authors: Fernanda
authors: F
authors: Settembrini
authors: Chiara
authors: C
authors: Gregorelli
authors: Gaetano
authors: G
authors: Musumarra
authors: Vincenzo
authors: V
authors: Rapisarda
mesh_terms: D000328:Adult; D000368:Aged; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D009558:Nipples / Q000601:surgery; D017060:Patient Satisfaction; D010369:Pectoralis Muscles / Q000637:transplantation*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult