ArticleCureus2025
Comparison of Superomedial Pedicle Reduction Mammaplasty With and Without Inferior Dermal Flap Support: A One-Year Study of Ptosis and Pseudoptosis.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionReduction mammaplasty effectively alleviates symptoms of breast hypertrophy, but long-term ptosis and pseudoptosis remain challenges. The superomedial pedicle technique ensures reliable nipple-areola complex (NAC) vascularity and upper pole fullness, though lower pole support is limited. This study evaluates the impact of adding an inferior dermal flap on postoperative breast shape stability. MATERIALS AND
methodsThis retrospective cohort study conducted at Kaunas Clinics included 54 overweight women who underwent bilateral reduction mammaplasty using a superomedial pedicle, with (Group 2, n = 26) or without (Group 1, n = 28) inferior dermal flap reinforcement. Exclusion criteria included age below 18, smoking, and systemic comorbidities. Patients were assigned to one of the two groups based on the technique: Group 1 underwent superomedial pedicle reduction without additional support, while Group 2 received the same technique with an inferior dermal flap anchored to the chest wall. Standardized anthropometric measurements (sternal notch-to-nipple (SN-N) and nipple-to-inframammary fold (N-IMF) distances) were recorded preoperatively, within 24 hours postoperatively, and at the one-year follow-up. Nipple-to-scar (n-scar) distance was measured only at the one-year follow-up. Statistical significance was set at p < 0.05.
resultsBaseline demographics and resection weights were similar between groups. Both techniques resulted in significant immediate postoperative reductions in the SN-N and N-IMF distances, with no significant intergroup differences. At one year, Group 2 showed superior lower pole support (median N-IMF: 8 cm vs. 9.5 cm, p < 0.0001) and shorter scars (median n-scar: 7.25 cm vs. 8 cm, p < 0.0001), while Group 1 retained a more stable SN-N distance (median: 21 cm vs. 22 cm, p = 0.0029).
conclusionThe addition of an inferior dermal flap to the superomedial pedicle technique in reduction mammaplasty significantly enhances long-term lower pole stability, reduces recurrence of ptosis and pseudoptosis, and improves scar quality. This approach is especially advantageous for patients with higher BMI or reduced tissue elasticity. Despite the slightly increased operative time, the improved contour durability and aesthetic outcomes support the routine use of dermal flap reinforcement in surgical planning.
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