Clinical Research On Improved Dermal Bra Technique And Arms-plumbing Technique In Reduction Mammaplasty

Objective: Explore the clinical effect of both the improved dermal bra Technique and arms-plumbing technique.Methods: We made a retrospective analysis on 34 patients with breast hypertrophy in our hospital from January 2000 to June 2014. In observation group, 18 cases adopted the dermal bra Technique. In contrast group, 16 cases adopted arms-plumbing technique. The postoperative follow-up period lasted 6 months to 1 year and the evaluative perimeters are: improvement in symptoms, patient satisfaction(post-operative overall breast shape, shape and position of the nipple and areola sensation, scarring etc.), evaluation on surgery of doctors, data measurement of breast preoperative and postoperative( the distance between the nipple to the sternal notch, the distance between the two nipples, areola diameter, nipple bra), the resected tissue content in operation and complications.Results: In both groups, patients showed significantly reduced breast volume and relieved symptoms. In observation group, the breast tissue above the nipple and areola were suspended on the pectoralis major fascia, making breasts look tall, round and natural with little and hidden scar, while poor wound healing in one case and expansion of the areola in two cases. In contrast group, breast shapes were tall and straight, but scars were obvious. Two cases showed incision dehiscence and two cases had fat liquefaction. In four cases, the breast surgery scar showed obvious hyperplasia. There was no significant difference on overall shape, nipple areola appearance and patient satisfaction between the two groups. However, nipple sensation and scar satisfaction were significantly better in observation group than in contrast group. Physician evaluation was consistent with patient satisfaction. In observation group, nipple moved up around(7.98±1.70)cm. Averagevolume of excised tissue was(596.61±152.43)g, which was similar to contrast group. Complications in observation group were significantly less than in contrast group.Conclusion: Both improved dermal bra technique and arms-plumbing technique were widely used in clinical application with advantages and disadvantages respectively. Arms-plumbing technique was designed complexly with sufficient blood supply and tissue resection. For the surgery left inverted T-shaped scar and reduced nipple sensation, it was suitable for patients with moderate to severe or super severe breast hypertrophy and less demanding on the appearance of scars. The dermal bra technique removed excess tissue without affecting the blood supply and breast shaping, thus could widely used in patients with mild, moderate or severe symptoms. The operation retains nipple sensation and lactation. The scars are small and hidden. Therefore,for patients with high demands on the appearance of scars, improved dermal bra technique was better than arms-plumbing method in reduction mammaplasty.