Long-term Breast Shape Analysis After Short-scar Reduction Mammaplasty: A Critical View.

Background: Over the past 2 decades, vertical scar reduction mammaplasty techniques have been gaining more acceptance. However, many surgeons are still hesitant to use it routinely because of the uncertainty of the effectiveness of vertical scar techniques in managing lower pole skin excess. We aimed to test its efficacy by using objective anthropometric measurements to evaluate long-term breast shape and lower pole stability.

Methods: The study population included 40 of 129 consecutive women with short-scar reduction mammaplasty followed up for at least 1 year. Breasts were measured preoperatively, perioperatively, and at least 1 year postoperatively. All women also completed the BREAST-Q questionnaire at their most recent visit.

Results: The mean sternal notch-to-nipple and upper breast-to-nipple distances decreased postoperatively by 22% and 43%, respectively, and remained stable over a mean time of 110.1 ± 65.58 weeks. The nipple-to-inframammary fold distance, which was intraoperatively shortened by an average of 63%, elongated back to 88% of its preoperative measurements. No correlation was detected between the long-term changes across all 3 measurements, the amount of tissue removed or the satisfaction reported by patients. Mean BREAST-Q satisfaction rates in all parameters evaluated were 75.79-98.12.

Conclusions: The 12% improvement in the nipple-to-inframammary fold measurement implies that the short-scar technique might properly address the horizontal dimension of the hypertrophic-ptotic breast but falls short in addressing its vertical dimension. The search for a modification that mirrors the advantages of the vertical scar technique in terms of shape and projection, while guaranteeing a steady lower pole, remains ongoing.