Vertical scar reduction mammoplasty in massive macromastia: A prospective case series

IF 1.8 Q3 SURGERY

JPRAS Open Pub Date : 2026-03-01 Epub Date: 2026-01-16 DOI:10.1016/j.jpra.2026.01.012

Yahia Ahmed Alsiaghi , Mohammed Hasan Al Shoaibi , Mohaned Yahia Al-ajaly , Jehad Yahya Al Mortada , Aymen Mohammed Ghanem , Ahmed A․ S․ AL-Magedi

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引用次数: 0

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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纵向瘢痕缩小乳房成形术治疗巨乳症：前瞻性病例系列

背景：垂直瘢痕上内侧蒂乳房复位术可缩短瘢痕，改善乳房投影，但其在严重巨乳症患者中的安全性和预后仍有待讨论。方法于2022年10月至2025年1月进行前瞻性病例系列研究，纳入胸骨上切口到乳头距离≥30 cm或每乳切除重量≥750 g的女性患者15例（30个乳房）。所有患者均采用上内侧椎弓根技术进行垂直瘢痕复位乳房成形术，随访12个月。结果患者平均年龄为33.7±8岁，平均BMI为28.3±3.9 kg/m²。平均切除组织为812.4 g（右）和794.5 g（左）。常见的症状为颈/背/肩痛（100%）、肩沟（93.3%）和社交尴尬（93.3%）。早期并发症极少，包括2例伤口裂开（13.3%），2例乳头-乳晕部分坏死（13.3%），1例感染（6.7%）。未见血肿或血清肿。晚期结果显示乳房形状（93.3%）、体积（80%）、疤痕（80%）和乳晕外观（86.7%）良好，53.3%的病例对称。患者满意度很高，80%的人认为结果“非常好”或“优秀”。只有20%的患者需要二次翻修。并发症与吸烟、肥胖或切除体重之间没有统计学上的显著关联。结论垂直瘢痕上内侧蒂缩乳术是治疗重度巨乳症安全有效的方法。它提供了良好的美学效果，最小的并发症，和高患者满意度，即使在高bmi人群。这些发现支持其作为治疗广泛乳房肥大的可靠的一线手术选择的作用。

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来源期刊

JPRAS Open Medicine-Surgery

CiteScore

1.60

自引率

0.00%

发文量

审稿时长

22 weeks

期刊介绍： JPRAS Open is an international, open access journal dedicated to publishing case reports, short communications, and full-length articles. JPRAS Open will provide the most current source of information and references in plastic, reconstructive & aesthetic surgery. The Journal is based on the continued need to improve surgical care by providing highlights in general reconstructive surgery; cleft lip, palate and craniofacial surgery; head and neck surgery; skin cancer; breast surgery; hand surgery; lower limb trauma; burns; and aesthetic surgery. The Journal will provide authors with fast publication times.