title: Semicircular Horizontal Approach in Breast Reduction: Clinical Experience in 38 Cases.
abstract: BACKGROUND
  Various techniques are used for performing breast reduction. Wise-pattern and vertical scar techniques are the most commonly employed approaches. However, a vertical scar in the mid-lower breast is prominent and aesthetically less pleasant. In contrast, a semicircular horizontal approach does not leave a vertical scar in the mid breast and transverse scars can be hidden in the inframammary fold. In this paper, we describe the experiences and results of semicircular horizontal breast reductions performed by a single surgeon.
  
  
  METHODS
  Between September 1996 and October 2013, our senior author used this technique in 38 cases in the US and at our institution. We used a superiorly based semicircular incision, where the upper skin paddle was pulled down to the inframammary fold with the nipple-areola complex pulled through the keyhole.
  
  
  RESULTS
  The average total reduction per breast was 584 g, ranging from 286 to 794 g. The inferior longitudinal pedicle was used in all the cases. The average reduction of the distance from the sternal notch to the nipple was 13 cm (range, 11-15 cm). The mean decrease in the bra cup size was 1.7 cup sizes (range, a decrease of 1 to 3). We obtained very satisfactory results with a less noticeable scar, no complication such as necrosis of the nipple or the skin flap, wound infection, aseptic necrosis of the breast tissue, or wound dehiscence. One patient had a small hematoma that resolved spontaneously.
  
  
  CONCLUSIONS
  This technique is straightforward and easy to learn, and offers a safe, effective, and predictable way for treating mammary hypertrophy.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Hee Su
authors.initials: HS
authors.lastname: Shin
authors.affiliation: Department of Plastic and Reconstructive Surgery, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Yong Hae
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Department of Plastic and Reconstructive Surgery, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Sung Gyun
authors.initials: SG
authors.lastname: Jung
authors.affiliation: Department of Plastic and Reconstructive Surgery, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Doo Hyung
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Plastic and Reconstructive Surgery, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Young
authors.initials: Y
authors.lastname: Roe
authors.affiliation: Department of Plastic and Reconstructive Surgery, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Jong Hyun
authors.initials: JH
authors.lastname: Cha
keywords: Breast; Mammaplasty; Nipples