title: Analysis of Lower Breast Pole Length and Nipple-Areola Complex Position Following Superior Pedicle, Short Horizontal Scar Breast Reduction.
abstract: BACKGROUND
  Postoperative changes following superior pedicle breast reduction are closely related to the pattern of skin resection. We have observed that the superior pedicle, short horizontal scar breast reduction technique provides a stable breast shape in the long term. We test the validity of our clinical observations through objective analysis of postoperative dimensional changes following superior pedicle, short horizontal scar breast reduction.
  
  
  METHODS
  Of 42 patients who underwent superior pedicle, short horizontal scar breast reductions between January 2011 and June 2012, 38 (75 breasts) were available for long-term follow-up. The midclavicular point-to-superior areolar border distance (A), the inferior areolar border-to-inframammary fold (IMF) distance (B), and the areolar diameter (C) were measured and recorded at the time of (1) preoperative markings, (2) first postoperative visit, and (3) 2-year postoperative follow-up visit. The specifications of the preoperative markings were recorded to analyze their correlation with actual breast dimensions.
  
  
  RESULTS
  The superior border of the nipple-areola complex (NAC) was located, on average, 1.2 cm higher at the first postoperative visit when compared with the markings (P < 0.001). The nipple-areola position did not change significantly in the long term (P = 0.224). The average postoperative increase in the IMF-to-inferior areolar border distance between the first postoperative visit and the long-term follow-up visit was 0.3 cm (P < 0.001). Although statistically significant, this extent of change (4.5 %) in the lower pole vertical length was clinically unidentifiable, and pseudoptosis did not occur after superior pedicle, short horizontal scar mammaplasty.
  
  
  CONCLUSIONS
  Long-term stability of the NAC position and lower breast pole length makes superior pedicle, short horizontal scar breast reduction a predictable and dependable option for primary breast reduction/mastopexy and for a matching procedure.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Department of Plastic Surgery, Hacettepe University Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey. ozanbitik@hacettepe.edu.tr.|Department of Plastic Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. ozanbitik@hacettepe.edu.tr.
authors.forename: Ozan
authors.initials: O
authors.lastname: Bitik
authors.affiliation: Department of Plastic Surgery, Hacettepe University Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Uzun
mesh_terms: D000328:Adult; D001940:Breast / Q000033:anatomy & histology; D002921:Cicatrix / Q000517:prevention & control*; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D009558:Nipples / Q000033:anatomy & histology; D056888:Patient Positioning; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000637:transplantation*; D013536:Suture Techniques; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*; D055815:Young Adult
keywords: Breast reduction; Nipple–areola position; Short horizontal scar; Superior pedicle