Over 10 Years' Follow-Up Experience after Inverted-T Superior Pedicle Breast Reduction with the Modified Ribeiro Flap.

Background: Several techniques have been developed to address cases of macromastia. The primary objective remains achieving optimal aesthetic outcomes and reducing breast volume, but concerns persist regarding the stability of results over time. In particular, as far as the superior pedicle inverted-T breast reduction with an inferiorly based dermal flap is concerned, long-term reported results stop at 5 years' follow-up. This work investigates the outcome of this at greater than 10 years' follow-up, considering intrinsic and extrinsic factors that may contribute to ptosis recurrence.

Methods: A total of 70 patients were included and examined in a long-term consultation, more than 10 years postoperatively. Physical measures, including standard breast distances, skin distention test for elasticity assessment, and BREAST-Q scores, were collected at the time of consultation and compared with preoperative and intraoperative data.

Results: The authors' study sample shows a mean age of 42 years. Mean follow-up was 13 years, with 18 years as the longest follow-up registered. Mean amount breast tissue volume removed was 1134 g. A positive correlation between smoking habit and inferior pole elongation is shown ( P = 0.031), and between smoking habit and inferior pole skin distention ( P = 0.002). A significant positive correlation between age and almost all the BREAST-Q scales is reported. Smoking patients had a higher sternal notch-to-nipple distance distance variation over time and superior pole skin distention.

Conclusions: Intrinsic and extrinsic factors may affect outcome and satisfaction irrespective of the age. This versatile procedure demonstrates reliability across time, offering enduring results.

Clinical question/level of evidence: Therapeutic, IV.