Unfavorable outcomes with vertical reduction mammaplasty: part II.

Background: Vertical reduction mammaplasty is a procedure that has steadily increased in popularity in the United States. Although numerous techniques exist for performing this operation, the adverse outcomes are similar in nature regardless of the approach. The authors previously evaluated patient satisfaction with vertical reduction mammaplasty in 260 consecutive patients in Part I.

Objective: This study evaluates the unfavorable outcomes encountered by the authors in the same patients included in Part I and examines the range of complications seen in other studies.

Methods: The authors reviewed the charts of 260 consecutive patients who underwent vertical reduction mammaplasty by the senior author at one of four institutions. All surgeries were performed through a superior pedicle vertical incision technique with varying amounts of liposuction.

Results: Unfavorable outcomes at our institution included scarring (10%), necrosis (1.92%), wound dehiscence (10%), areola asymmetry (6.54%), breast distortion or asymmetry (15%), and hematoma or seroma formation (1.54%). The results varied greatly in severity and necessity of intervention.

Conclusions: While there is a wide spectrum of complication rates among the different techniques of vertical reduction, the outcomes are often similar. The authors have observed these complications in a broad patient demographic and believe that the examples provided in this article can be extrapolated to other vertical incision techniques. An assessment of these complications is necessary to provide patients with proper preoperative counseling about the risks and consequences of these potential sequelae. In our experience, more significant resection and suction produced less cosmetically favorable results.