Ijaz Hussain Shah, Naveed Ahmad Khan, Sana Shaukat Siddiqui.
Breast reduction: Combination is best.
J Sharif Med Dent Coll Jan ;1(2):63-6.

Objective: In this prospective study, we describe our experience of breast reduction with combine three techniques approach, aimed at addressing three different aspects of breast reduction: skin reduction, shaping and nipple areolar complex shaping. Methodology: We assessed the outcome of 20 consecutive cases perioperative and postoperatively (for a mean of 12 months) in women who underwent breast reduction surgery involving a combination of three techniques: "inverted T" skin reduction, modified Hall-Findley supero medial pedicle for glandular reduction, and inferior de-epithelialized flap (modified "Foustanos" flap) for molding and improved shaping of the breast. The final bra cup size was C or D in all patients. Results: The overall results were graded as excellent in eight patients and very good in twelve patients. Each patient was completely satisfied with her surgery. Twelve patients developed venous congestion of the nipple areolar complex, which resolved within 24-48 hours after surgery. Four patients had uneventful delayed wound healing in the vertical scar of the inverted T pattern. Nipple-areolar complex survival rate was 100%. No patient had a major adverse event, permanently altered nipple areolar complex sensitivity, or bottoming out of the lower pole. None required revision surgery. Conclusion: This study confirms our expectations that a single procedure with a combination of different techniques is both effective and safe. Keywords: Breast reduction. Combination of techniques. Skin reduction. Gland reduction. "Foustanos "flap. Nipple areolar complex shaping.

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