Reduction Mammoplasty

Question 1

What is the purpose of a Reduction Mammoplasty (Breast Reduction)?

Answer 1

• Reduce size of breast due to macromastia

- Corrects breast ptosis (drooping breast)

Question 2

What is Patient Positioning for a Reduction Mammoplasty?

Answer 2

• Supine with Arms in Arm Boards at 90 degrees

- Patient’s hip aligned with hinge part of OR bed

Question 3

What are the key instruments needed for a Reduction Mammoplasty?

Answer 3

• Scale (to weigh grams of tissue removed)
• Facelift retractors
• Cookie Cutters (42 mm, 45mm, 48 mm, 50 mm)
• Bovie

Question 4

What are the three reduction techniques that can be used for a Reduction Mammoplasty?

Answer 4

• Vertical breast reduction
• Anchor pattern reduction (most common)
• Fee Nipple graft

Question 5

When is a Vertical Breast Reduction performed?

Answer 5

For smaller breasts

• Essentially a breast lift
• Vertical scar on breast after surgery

Question 6

When is an Anchor Pattern Breast Reduction performed?

Answer 6

For traditional macromastia patients

-Anchor scar on breast after surgery

Question 7

When is a Free Nipple Breast Reduction Performed?

Answer 7

For large patients that want to go really small

Question 8

What is a Breast Pedicle and what are the different types?

Answer 8

Vascularized tissue bundle supplying the Nipple-Areola complex

• Superior
• Inferior
• Medial (most popular- more fullness towards midline)
• Lateral

Question 9

What are the steps for a Reduction Mammoplasty?

Answer 9

1. Incisions are marked pre-operatively
2. Nipple-Areola complex marked with Cookie Cutters
3. Nipple-Areola complex deepithelialized
4. Incision completed and breast flaps dissected
5. Breast tissue excised from flaps except from pedicle
6. Flaps closed over pedicle
7. New Nipple-Areola complex positioned and sutured

Question 10

What blade is used to perfectly cut around the Nipple?

Answer 10

15 blade

Question 11

What suture is used to close the Breast Flaps over the Pedicle?

Answer 11

2-0 Vicryl

-3 way stitch at the midline

Question 12

What suture is used to close the Dermis during a Reduction Mammoplasty?

Answer 12

3-0 Vicryl (CT1 Needle)

Question 13

What suture is used to close around the Nipple-Areola Complex?

Answer 13

4-0 Vicryl (PS2 Needle)

Question 14

What suture is used to close the Skin after a Reduction Mammoplasty?

Answer 14

4-0 Monocryl (PS2 Needle)

Question 15

What dressings are used after closing a Reduction Mammoplasty?

Answer 15

• Dermabond Prineo
• ABDs
• Bra (1-2 sizes bigger to prevent compression)