title: Inferior pedicle breast reduction: a retrospective review of technical modifications influencing patient safety, operative efficiency, and postoperative outcomes.
abstract: BACKGROUND
  The inferior pedicle technique remains the most popular approach to breast reduction in the United States. Modifications to this procedure have enhanced versatility, patient safety, and outcome satisfaction in patients with all degrees of macromastia.
  
  
  METHODS
  A 6-year retrospective review of 241 patients who underwent bilateral inferior pedicle breast reduction was conducted at our institution. Modifications analyzed included methylene blue tattooing to provide preoperative landmarks, preoperative hydrodissection to reduce intraoperative blood loss, incorporation of inframammary darting to reduce tension at the "T-junction," preservation of superomedial volume for enhanced medial fullness, and dermatome blade-guided tissue resection.
  
  
  RESULTS
  Inframammary darting reduced the incidence of wound dehiscence. Preoperative hydrodissection reduced intraoperative blood loss by a factor of 2. Dermatome blade use reduced operative times at no increased incidence of postoperative seromas or hematomas.
  
  
  CONCLUSIONS
  Outcomes resulting from these modifications appear to be at least comparable to, and perhaps better than, those previously reported.
authors.affiliation: Department of Surgery, Division of Plastic, Aesthetic, Reconstructive Surgery, University of Miami Health System, Miami, FL 33136, USA.
authors.forename: Michael V
authors.initials: MV
authors.lastname: DeFazio
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Fan
authors.forename: Yash J
authors.initials: YJ
authors.lastname: Avashia
authors.forename: Jun
authors.initials: J
authors.lastname: Tashiro
authors.forename: Steven
authors.initials: S
authors.lastname: Ovadia
authors.forename: Tarik
authors.initials: T
authors.lastname: Husain
authors.forename: Liliana
authors.initials: L
authors.lastname: Camison
authors.forename: Zubin J
authors.initials: ZJ
authors.lastname: Panthaki
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Salgado
authors.forename: Seth R
authors.initials: SR
authors.lastname: Thaller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001940:Breast / Q000002:abnormalities / Q000601:surgery; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000601:surgery*; D016014:Linear Models; D016015:Logistic Models; D016462:Mammaplasty / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D061214:Patient Safety; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult