Small Scars, Large Results: The Integrated “Vertical” Technique for Breast Reduction Surgery
The Best of Both Worlds
When considering breast reduction, many patients are caught between two desires. They want a significant reduction in size, but they also want to avoid the long horizontal scar of a traditional “Anchor” reduction.
The Lejour Vertical Technique is famous for reducing scars, but some believe it is only for small procedures. However, surgeons in Charleston have developed a way to integrate the Central Mound technique with vertical skin removal to handle larger cases safely.
How the Integrated Technique Works
This approach is unique because it combines internal tissue shaping with external skin management.
- Vertical Skin Resection: This limits the scar to a “lollipop” shape, significantly decreasing visible scarring.
- Central Mound Reduction: By removing tissue from the central and superior (upper) part of the breast, surgeons can remove 400 to 1000 grams per side while preserving the blood supply and feeling in the nipple.
- Internal Support: Unlike other methods, the tissue at the bottom (inferior pedicle) is folded on itself. This acts like an internal bra, providing better support and projection.
The Role of Liposuction
A major part of this technique is the use of extensive liposuction in the lateral breast and underarm (axilla) areas.
- Efficiency: Up to two-thirds of the breast tissue can sometimes be removed using liposuction alone if the breast is composed mostly of fat.
- Safety First: Surgeons carefully avoid liposuction in the center of the breast to protect the blood supply to the nipple.
Is This Technique Right for You?
This integrated approach is ideal for candidates who need a moderate to large reduction (up to 1000g per side) but prioritize a smaller scar.
Important Considerations:
- Nipple Placement: If your nipple needs to be moved more than 8 cm vertically, a different procedure may be safer.
- Patience is Key: It can take up to 6 months for the final shape of the breast to settle and develop.
- Smoking Status: Smoking significantly reduces the safety of this procedure and the distance a nipple can be moved.
Conclusion
By integrating the central mound with the vertical scar technique, surgeons can offer “superior shaped” results through much smaller incisions. It is a powerful option for achieving significant relief from heavy breasts without the traditional “Anchor” scar.
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Frequently Asked Questions (FAQ)
Q: Will I lose sensation in my nipples?
A: This specific combination of techniques is designed to preserve the innervation (nerve supply) to the nipple-areola complex even during large reductions.
Q: What is “tumescent fluid”?
A: It is a solution injected into the breast before surgery that helps with liposuction and reduces bleeding.
Q: Do I need a mammogram first?
A: According to the study’s protocol, mammograms are routinely obtained for patients over 35 or those with a family history of breast cancer.
Reference
- [1] Hagerty, Richard C. M.D., and Nowicky, David J. M.D. “Integration of the Central Mound Technique with the Vertical Skin Takeout Reduction Mammaplasty.” Medical University of South Carolina.