The Safety of Long Inframammary Fold to Nipple Lengths in Inferior Pedicle Breast Reductions: A Decade of Experience.

BACKGROUND: Breast reduction is one of the most common procedures performed by plastic surgeons, and the inferior pedicle is a technique frequently used to maintain vascular supply to the nipple areolar complex (NAC). One of the relative contraindications for its use is the presence of a long nipple-to-inframammary fold (IMF) length; however, in the authors' practice, inferior pedicle mammoplasties have been successfully performed for over 10 years on almost all patients.

METHODS: The authors performed a retrospective study including patients who underwent bilateral breast reduction with inferior pedicle technique from October 2009 to April 2021 by 2 different surgeons in New Orleans, Louisiana. Patient baseline characteristics as well as surgical outcomes were recorded.

RESULTS: The study population consisted of 221 patients and 436 breasts. The average age of patients was 38 years, and average body mass index was 32.35 kg/m2 . Average follow-up time was 135 days. The average nipple-to-IMF distance for the patient population was 16.03 cm, and the average pedicle width of the inferior pedicles used for breast reductions was 10 cm. There was no incidence of total nipple necrosis. The most common complication was a superficial wound at the T junction of the breast reduction incision (23%).

CONCLUSIONS: Breast reductions with an inferior pedicle are safe to perform, without the risk of nipple necrosis, for all patients with inferior pedicle length up to 33 cm.