Breast Reduction, Inferior Pedicle Technique
For the majority of my breast reduction surgeries performed weekly, I perform my reductions using the inferior pedicle Wise-pattern technique. The inferior pedicle technique removes tissue from the inner and outer sides of the breast and above the inferior pedicle superiorly. After removing the medial and lateral dermoglandular wedge, the inferior pedicle is raised superiorly and the nipple areolar complex is maintained on this inferior pedicle which is attached to the chest wall pectoralis fascia. In some cases where the base pedicle is narrow, a bi-pedicle technique can be used where dissection superiorly is not carried down to the fascia. This maintains an excellent blood supply to the inferior pedicle when it thin or narrow, less than 8 mm in base width. We perform breast surgeries in our Medicare licensed ambulatory Beverly Hills Surgery Center weekly. Breast reductions require specialized Board Certified Plastic and Reconstructive Surgeons who have the ability to understand the anatomy of the chest wall, blood supply and nerves. Maintaining the inferior pedicle as thick as possible will increase survivability of the nipple areolar complex.
The picture shows the inferior pedicle where tissue has been removed both along the medial and lateral quadrants and the inferior pedicle above will be superiorly retropositioned and the medial and lateral flaps will be sutured down to the midline of the inframammary fold. Scarring on breast reductions are the number one concern and this can be minimized by meticulous suture technique postoperative silicone gel scar treatment using Bio corneum for up to three to six months and scar revisions as necessary after one year.