title: 3-D analysis of breast morphology changes after inverted T-scar and vertical-scar reduction mammaplasty over 12 months.
abstract: One major objective of all types of breast reduction procedures is to achieve a long-lasting, stable and aesthetically pleasing three-dimensional (3-D) breast shape, but current surgical outcome evaluation is limited. This study compares the extent of soft-tissue oedema and breast tissue migration related to 3-D breast morphology changes after inverted T-scar and vertical-scar breast reduction over 12 months. 3-D breast surface scans of patients undergoing inverted T-scar (n=52 breasts) and vertical-scar (n=44 breasts) reduction mammaplasty were obtained preoperatively and 2-3 days, 1 week, 1 month, 3 months, 6 months, 9 months and 12 months postoperatively. 3-D images were analysed at each time point comparing distances, 3-D breast contour deviations (%), breast surface (cm2) and volume (cc) measurements including volumetric distribution between the upper portion (UP) and the lower portion (LP) of the breast (%). Total postoperative breast volume decreased by 11.7% (T-scar) and by 7.8% (vertical-scar) during the first 3 months (both p<0.001) without relevant changes in the following months, indicating that soft-tissue oedema is resolved after 3 months. The T-scar (vertical-scar) group showed a preoperative UP to LP volumetric distribution of 43:57% (45:55%) versus 86:14% (91:9%) immediately after surgery. Breast tissue significantly redistributes (both p=0.001) from the UP to the LP during the first postoperative year by 16.5% (T-scar) and 21% (vertical-scar), resulting in a final UP to LP ratio of 70:30% for both techniques, without further breast contour deviations (both p>0.05) after 6 months (T-scar) and 9 months (vertical-scar). Breast morphological changes after reduction mammaplasty are completed after a period of 3-6 months in the T-scar group and 6-9 months in the vertical-scar group.
authors.affiliation: Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, D-81675 Munich, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Eder
authors.forename: Markus
authors.initials: M
authors.lastname: Klöppel
authors.forename: Daniel
authors.initials: D
authors.lastname: Müller
authors.forename: Nikolaos A
authors.initials: NA
authors.lastname: Papadopulos
authors.forename: Hans-Günther
authors.initials: HG
authors.lastname: Machens
authors.forename: Laszlo
authors.initials: L
authors.lastname: Kovacs
mesh_terms: D000328:Adult; D001940:Breast / Q000033:anatomy & histology* / Q000601:surgery; D002921:Cicatrix / Q000453:epidemiology / Q000517:prevention & control*; D004487:Edema / Q000453:epidemiology; D004954:Esthetics; D005260:Female; D006801:Humans; D007834:Lasers; D016462:Mammaplasty / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D013524:Surgical Flaps; D016896:Treatment Outcome