Factors influencing the shape, size, symmetry and scar of the nipple-areola complex after bilateral reduction mammoplasty.

Background: Asymmetry and scar formation of the nipple-areola complex (NAC) after reduction mammoplasty with periareolar suture are common complications and can significantly affect patient satisfaction.

Objective: The aim of this study was to investigate possible procedure-specific influencing factors on asymmetry and shape disturbances of the nipple-areola complex to optimize postoperative outcome and thus improve patient satisfaction.

Methods: 78 patients were followed-up after a 5-year period as part of a retrospective cohort study.

Re-evaluating the Lejour Technique for Breast Reduction in Patients with Macromastia.

Background: Limited scar Lejour technique for breast reduction is conventionally used to remove less than 500 g of breast tissue per breast, but is effective for greater macromastia. Plastic surgery residents gain limited experience with this technique, and it is infrequently performed in the United States. To understand technique selection, we surveyed board-certified plastic surgeons and compared outcomes with the Lejour technique in 1 practice to those with other methods.

Tuberous breast deformity: A modified technique for single-stage correction.

Introduction: Tuberous breast deformity is one of the most challenging congenital breast anomalies. Severe forms present as hypoplasia of lower medial and lateral quadrants and breast base constriction. We present a modified technique based on redistribution of breast tissue for single-stage aesthetic correction of this deformity.

Managing Complications in Vertical Mammaplasty.

In this paper, we describe our experience with the Lejour vertical scar mammaplasty from its description throughout 25 years of practice. Our work aims to focus on reducing vertical scar mammaplasty complications by examining results, studying how to avoid unfavorable consequences, and providing new tips to improve the technique and shorten its learning curve. Complications can be related to patient characteristics and habits, but adhering to a strict surgical protocol is essential to limit other factors.

A mathematical design in creating the new nipple-areolar complex in vertical mammaplasty.

Vertical mammaplasty for breast reduction has been widely popularized by Lejour. In her planning for the new nipple-areolar complex, she did not specify a method of drawing the periareolar curve, leaving it to the surgeon's creativity. We have designed a simple method using mathematics to draw the new periareolar curve consistently and reliably, not requiring any additional or complex devices.

Comparing reduction mammaplasty specimens between superior and central pedicle techniques: a retrospective study.

Unlabelled: The aim of this study was to evaluate the histologic diagnoses of the reduction mammaplasty specimens in two retrospective series of patients operated using superior and central pedicle mammaplasties. Between November 2000 and December 2011, 60 consecutive patients (120 breasts) underwent breast reduction using the superior pedicle technique with a vertical scar (Lejour's technique). These patients were compared with another series of 80 patients (150 breasts) who underwent breast reduction using a vertical scar mammaplasty with a central pedicle (Copcu's technique).

The evolution of breast reconstruction: a historical perspective.

Plastic surgeons have been performing operations to improve the aesthetic aspect of the breast for centuries. Throughout ancient times, great controversy produced many theories of how breast cancer occurred and the best treatment. Because of beliefs that closure of mastectomy sites could conceal tumor recurrence, breast reconstruction did not gain wide acceptance until the mid-1900s.

Superior pedicle autoaugmentation mastopexy: a review of 34 consecutive patients.

Background: The ptotic breast deformity results from two synergistic forces: involution of breast parenchyma leading to a loss of volume, along with a converse laxity of the skin envelope, which becomes inelastic and accommodating. As the breast tissue descends inferiorly on the chest wall with gravity, there is an apparent volume loss in the upper pole and the central breast, and the lower pole becomes fuller and often wider.

Objectives: The authors propose a technique whereby the superior pedicle vertical mammaplasty technique originally described by Lassus is modified to include transposition of glandular tissue to restore central mound projection while simultaneously narrowing the lower breast base and raising the inframammary crease.

[Vertical reduction mammaplasty with wide superior pedicle].

Objective: To report the reduction mammaplasty with vertical incision and superior wide pedicle.

Methods: Typical Lejour mosque-dome design was performed. The inferior part of glandular tissue and skin were excised.

Practice profiles in breast reduction: a survey among Canadian plastic surgeons.

Background: Breast reduction is an increasingly common procedure performed by Canadian plastic surgeons. Recent studies in the United States show that use of the inferior/central pedicle inverted T scar method is predominant. However, it is unknown what the practice preferences are among Canadian plastic surgeons.

Selective breast reduction: a personal approach with a central-superior pedicle.

Background: Breast reduction shows a greater risk of complications in peculiar cases such as those with gigantomastia, a high degree of ptosis, obesity, smoking, cardiovascular diseases, or metabolic disorders. The authors feel that a reduction in the complication rate can be achieved by safeguarding the vascular and nervous structures of the breast as much as possible.

Methods: The authors propose a breast reduction method based on a double central-superior pedicle that was used in 91 patients with a more or less elevated degree of obesity.

[Modification of Lejour reduction mammaplasty--mammaplasty of L-shaped scar].

Objective: To introduce a modification of Lejour reduction mammaplasty.

Methods: With the upper pedical flap as the base of mammaplasty, the lower part of breast was resected while excess skin was pushed to lateral and formed "L"-shaped scar after it was resected.

Results: From October 2005 to April 2006, the modified Lejour reduction mammaplasty was applied to 10 mammahypertrophic patients with 20 breasts in sum.

Breast reduction: modified "Lejour technique" in 500 large breasts.

Background: The "minimal scar technique" for breast reduction, developed by Marchac, Lassus, and Lejour, has become an increasingly practiced alternative to standard operative procedures.

Methods: The authors introduced the modified "Lejour technique" in nearly 500 breast reductions in 250 overweight patients (adipose breasts) with a resection weight of more than 700 g. Their technique is a step-wise modification of the following procedures, resulting from their experience with complications and outcomes.

Gigantomasty: treatment with a short vertical scar.

Background: During the past 15 years, reduction mammoplasty with a short vertical scar has become increasingly common in the world of plastic surgery. Still, the indication for this technique often is limited to smaller reduction weights, so that the inverted T-scar techniques have yet to be regarded as the gold standard for excessive breast hypertrophy.

Methods: In the authors' department, their own modification of vertical scar reduction mammoplasty, based on the techniques of C.

Vertical scar mammaplasty in gigantomastia: retrospective study of 115 patients treated using the modified lejour technique.

Since 1996, the original technique of superior pedicle vertical scar mammaplasty described by Lejour has been modified by decreasing skin and glandular undermining, limiting liposuction, avoiding tight glandular stitches, and adding a small horizontal scar for very large breasts. Between 1996 and 2002, 115 consecutive patients underwent a bilateral reduction mammaplasty of more than 500 g per breast using the modified Lejour technique. The early, late, and delayed complications were studied according to four parameters: glandular resection, age, smoking habits, and body mass index (BMI).

Refinements of the LeJour vertical mammaplasty skin pattern for skin-sparing mastectomy and immediate breast reconstruction.

Background: Skin-sparing mastectomy (SSM) is a well-established technique for immediate breast reconstruction (IBR). When used for large and/or ptotic breasts, traditional SSM patterns produce long skin flaps prone to necrosis or 'T' junction breakdown. The authors have previously demonstrated the applicability of the LeJour-type vertical mammaplasty skin pattern to this group of patients.

Breastfeeding after vertical reduction mammaplasty using a superior pedicle.

Between January 1996 and December 2002, 189 women underwent bilateral superior-pedicle breast reduction according to the Lejour technique, at Brugmann University Hospital (Brussels, Belgium). We conducted a retrospective study on the 18 women who gave birth since the operation. Our aim was to find out how many of them breastfed, the reasons for not breastfeeding from those who did not, and to look for parameters that might have interfered with breastfeeding success.

Technical refinements of the vertical mammaplasty: a modified lejour approach.

Although recent refinements in vertical mammaplasty techniques have increased the popularity of the procedure, criticism has continued on the basis of perceived shortcomings in the results. In this paper, a step-by-step description of the author's preferred vertical mammaplasty technique, the modified Lejour approach, is presented. Detailed guidelines are given for preoperative markings to site the proposed new nipple position, ensure breast symmetry, delineate breast displacement and the final medial and lateral extent of skin incision, and minimize "dimple-like" skin indentations at the lower border of the skin excision during closure.

Refinements of vertical scar mammaplasty: circumvertical skin excision design with limited inferior pole subdermal undermining and liposculpture of the inframammary crease.

Vertical scar mammaplasty, first described by Lötsch in 1923 and Dartigues in 1924 for mastopexy, was extended later to breast reduction by Arié in 1957. It was otherwise lost to surgical history until Lassus began experimenting with it in 1964. It then was extended by Marchac and de Olarte, finally to be popularized by Lejour.

Alteration of nipple and areola sensitivity by reduction mammaplasty: a prospective comparison of five techniques.

The preservation of the sensitivity of the nipple-areola complex after reduction mammaplasty is an important goal. The authors performed this prospective study to accurately assess whether sensitivity changes are influenced by the weight of resection or the surgical technique. Eighty patients who underwent bilateral breast reduction (Lassus, 10 patients; Lejour, 13 patients; McKissock, 18 patients; Wuringer, 20 patients; and Georgiade, 19 patients) were tested for sensitivity changes of the nipple and cardinal points of the areola with Semmes-Weinstein monofilaments before surgery, at 3 weeks, and at 3, 6, and 12 months after surgery.

A comparison of the LeJour and Wise pattern methods of breast reduction.

Supporters of the vertical mammoplasty state the resultant breast shape and scar are superior to the Wise pattern breast reduction. This study contains a comparison of the LeJour vertical reduction with the Wise pattern reduction by analysis of pre- and postoperative photographs, as well as a retrospective review comparing operative times, blood loss, complications, and a postoperative patient questionnaire. Of the 112 women who had moderate to large reductions (>500 g/breast) between 1999 and 2002, 65 subjects had adequate standard perioperative photographs.

[Vertical reduction mammaplasty].

Objective: The inverted "T" operation is a typical and classic method for breast hypertrophy. Although having good results, it leaves significant scar and tends to have bottom-out deformity with time. The purpose of this study is to introduce our experience in vertical mammaplasty.

Vertical reduction mammaplasty.

The patients seeking our help for breast reduction are very often young and probably planning to have children later in their lives. Therefore it is most important to offer them a method of reduction mammaplasty that leaves as little scars and as much physiological function as possible. The vertical reduction mammaplasty as we perform it is a method that leaves normal sensibility in almost all cases, the possibility of lactation, little scarring and a pleasant form.

New marking designs for vertical scar breast reduction.

According to the authors, a new marking design for vertical scar breast reduction avoids the tension at nipple level that may occur with the use of a mosque-shaped marking (Lejour technique). Furthermore, better symmetry may be achieved in placement of the areola and nipple.

An application of the LeJour vertical mammaplasty pattern for skin-sparing mastectomy: a preliminary report.

An application of the LeJour vertical mammaplasty skin pattern for skin-sparing mastectomy is presented. The approach provides adequate access for the mastectomy, axillary dissection, and immediate breast reconstruction. The technique is ideal for patients with large or ptotic breasts undergoing a simultaneous contralateral breast reduction or mastopexy.