A Formula for Planning and Predicting Postoperative Mammoplasty Results.
OBJECTIVE
For women with macromastia, reduction mammoplasty is a safe and effective solution to increasing quality of life through alleviating pain and improving aesthetics. This study developed a way to combine a surgeon's view of breast measurement (volume) with a patient's view of breast measurement (distance between nipple and notch, inframammary fold, or midline) to provide patients with a better understanding of expected surgical outcomes after breast reduction with a medial superior pedicle.


METHODS
An institutional review board approved retrospective chart review was performed on all medial superior pedicle reduction mammoplasties performed by a single surgeon at a university medical center from 2008 to 2016, and a total of 133 patients were identified. Measurements of interest for this study were nipple to sternal notch (N-S), nipple to inframammary fold (N-I), nipple to midline (N-M), and breast diameter (BD). The average bilateral change per measurement was calculated for each patient in centimeters. Change was averaged for left and right breasts for N-S, N-I, N-M, and BD per patient. Grams removed for left and right breasts were also averaged. Each measurement of average change was divided by the gram average and multiplied by 100 to obtain centimeter change per 100 grams. Individual patient measurements per type of measurement were averaged to achieve a final improvement reported in centimeters per 100 g tissue removed per breast.


RESULTS
The average change in the N-S distance was calculated to be a decrease of 1.5 ± 0.8 cm/100 g of breast tissue removed. The average change in N-I was calculated to be an overall decrease of 0.7 ± 0.5 cm/100 g. The average change in N-M was calculated to be a decrease of 0.1 ± 0.3 cm/100 g. Finally, the average change in BD was calculated to be 0.0 ± 0.4 cm/100 g.


CONCLUSIONS
A surgeon's expression of breast measurements in terms of volume can be difficult for a patient to understand and visualize. This study determined the impact volume has on length of typical breast measurements to increase patients' understanding of expected outcomes. In summary, patients can be told to expect to see a nipple elevation of 1.5 cm per 100 grams of breast tissue removed using this medial superior pedicle technique.
From the *UAB School of Medicine, Plastic Surgery, †UAB Division of Plastic Surgery/Department of Surgery, Birmingham, AL; ‡University of South Florida Morsani College of Medicine, Tampa, FL; and §University of Alabama School of Health Professions, Birmingham, AL.
Mary G
MG
Smithson
Sherry S
SS
Collawn
Mina S
MS
Mousa
Carly M
CM
Bramel
D000328:Adult; D001940:Breast / Q000002:abnormalities* / Q000601:surgery; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy / Q000175:diagnosis / Q000601:surgery*; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000379:methods; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome