ArticleJPRAS open2026
Vertical scar reduction mammoplasty in massive macromastia: A prospective case series.
Article in JPRAS open, 2026. 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
Background: Vertical scar superomedial pedicle breast reduction offers a shorter scar and improved breast projection, yet its safety and outcomes in cases of severe macromastia remain under discussion. Methods: A prospective case series was conducted from October 2022 to January 2025, including fifteen female patients (30 breasts) with suprasternal notch-to-nipple distance ≥30 cm or resection weight ≥750 g per breast. All underwent vertical scar reduction mammaplasty using a superomedial pedicle technique and were followed for 12 months. Results: The mean patient age was 33.7 ± 8 years, and the mean BMI was 28.3 ± 3.9 kg/m². Average resected tissue was 812.4 g (right) and 794.5 g (left). Common presenting symptoms were neck/back/shoulder pain (100%), shoulder grooving (93.3%), and social embarrassment (93.3%). Early complications were minimal, including wound dehiscence in two cases (13.3%), partial nipple-areolar necrosis in two cases (13.3%), and infection in one case (6.7%). No hematomas or seromas were observed. Late outcomes showed favorable results in breast shape (93.3%), volume (80%), scars (80%), and areola appearance (86.7%), with fair symmetry in 53.3% of cases. Patient satisfaction was high, with 80% rating the results as "very good" or "excellent." Only 20% of patients required secondary revision. No statistically significant association was found between complications and smoking, obesity, or resection weight. Conclusion: Vertical scar superomedial pedicle breast reduction is a safe and effective technique for patients with severe macromastia. It provides excellent aesthetic outcomes, minimal complications, and high patient satisfaction, even in high-BMI populations. These findings support its role as a reliable first-line surgical option in the management of extensive breast hypertrophy.
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