Eray Copcu

Abstract: Reduction mammaplasty and mastopexy is one of the biggest operation groups which have many techniques and their modifications. Generally accepted that, new modifications are the results of improvements of existing techniques. In this study we present a new modification of Moufarrege total posterior pedicle mammaplasty. We performed central plication to achieve a juvenile look in the superior pole of the breast and to prevent postoperative pseudoptosis and used central U shaped flap to achieve maximum NAC safety and to preserve lactation and nipple sensation. Sixty-nine patients were operated with the above mentioned tech-nique. Out of 69 patients, 52 underwent reduction mammaplasty (11 had gigantomastia), eleven mastopexy, and six oncoplastic. All of the patients were satisfied with functional and aesthetic results and none of them had major complications such as total NAC loss. Only six patients had wound healing problems on the suture line and two patients had minimal hematoma. Since we performed conical plication we would like to evalu-ate long term effects of the plication in the breast parenchyma. Breast parenchyma was visualized with USG in younger patients and mammography in older patient in postoperative 6 months and 1 year. We never observed any problem related with our sutures and retroareolar part of the areola examination for ductal patency was performed and interestingly all the patients had very clear ductal patency. Our modification is a safe, reliable technique which creates the least scar, avoids previously described disadvantages, provides maximum preservation of functions, can be employed in all breasts regardless of their sizes and is appropriate for oncoplastic surgery and revision surgery.

Keywords: Breast Reduction, Mammaplasty, Pedicle

Cite this paper: nullE. Copcu, "Modification of Moufarrege Total Posterior Pedicle Mammaplasty: Conical Plicated Central U Shaped (COPCU's) Mammaplasty," Surgical Science, Vol. 2 No. 2, 2011, pp. 80-88. doi: 10.4236/ss.2011.22018.

References

[1]   D. C. Hammond. “Breast Reduction”, Atlas of Aesthetic Breast Surgery, 2009, p. 146.

[2]   A. Berg, B. Stark E. and Malec, “Reduction Mammaplasty: A Way Helping Females with Neck, Shoulder and Back Pain Symptoms,” European Journal of Plastic Surgery, Vol. 17, No. 2, 1994, pp. 84-86.

[3]   E.Copcu, “A Versatile Breast Reduction Technique: Conical Plicated Central U Shaped (Copcus) Mammaplasty,” Annals of Surgical Innovation and Research, Vol. 3, No. 7, 2009.

[4]   E. J. Hall-Findlay, “Pedicles in Vertical Breast Reduction and Mastopexy,” Clinic Plastic Surgery, Vol. 29, No. 3, 2002, pp. 379-391.doi:10.1016/S0094-1298(02)00008-1

[5]   R. Moufarrege, G. Beauregard, J. P. Bosse, G. Muller, J. Papillon and C. Perras, “Reduction Mammoplasty by the Total Dermoglandular Pedicle,” Aesthetic Plastic Surgery, Vol. 9, No. 3, 1985, pp. 227-232. doi:10.1007/BF01570855

[6]   R. Moufarrege, 2006, http://www.emedicine.com/plastic/ topic488.htm

[7]   M. C. Ferreira, “Evaluation of Results in Aesthetic Plastic Surgery: Preliminary Observations on Mammaplasty,” Plastic and Reconstructive Surgery, Vol. 106, No. 7, 2000, pp. 1630-1635. doi:10.1097/00006534-200012000-00032

[8]   A. Ceydeli, J. Louis, J. Yu and E. Ritter, “Lateral Septal Preservation: a Technique to Improve Projection in Inferior Pedicle Reduction Mammaplasty by Preventing Lateral Displacement of the Pedicle,” Plastic and Reconstructive Surgery, Vol. 120, No. 4, 2007, pp. 1088-1089. doi:10.1097/01.prs.0000278185.71693.18

[9]   W. Hefter, P. Lindholm and O. P. Elvenes, “Lactation and Breast-Feeding Ability Following Lateral Pedicle Mammaplasty,” British Journal of Plastic Surgery, Vol. 56, No. 8, 2003, pp. 746-751. doi:10.1016/S0007-1226(03)00368-0

[10]   M. Y. Nahabedian, B. M. McGibbon and P. N. Manson, “Medial Pedicle Reduction Mammaplasty for Severe Mammary Hypertrophy,” Plastic and Reconstructive Surgery, Vol. 105, No.3, 2000, pp. 896-904. doi:10.1097/00006534-200003000-00011

[11]   T. R. Hester and J. Cukic, “Central Breast Pedicle and ‘Free-Hand’ Technique for Alteration of Volume and Skin Envelope of the Breast,” Clinic Plastic Surgery, Vol. 15, No. 4, 1988, pp. 613-625.

[12]   P. Andrades and A. Prado, “Understanding Modern Breast Reduction Techniques with a Simplified Approach,” Journal of Plastic, Reconstructive & Aesthetic Surgery, Vol. 61, No. 11, 2008, pp. 1284-1293. doi:10.1016/j.bjps.2007.11.060

[13]   I. Schlenz, S. Rigel, M. Schemper and R. Kuzbari, “Alteration of Nipple and Areola Sensitivity by Reduction Mammaplasty: a Prospective Comparison of Five Techniques,” Plastic and Reconstructive Surgery, Vol. 115, No. 3, 2005, pp. 743-751. doi:10.1097/01.PRS.0000152435.03538.43

[14]   S. O. Harbo, E. Jorum, H. E. Roald, “Reduction Mammaplasty: a Prospective Study of Symptom Relief and Alterations of Skin Sensibility,” Plastic and Reconstructive Surgery, Vol. 111, No. 1, 2003, pp. 103-110. doi:10.1097/00006534-200301000-00017

[15]   H. Biesenberger, “Ein Neue Methode Der Mammoplastik Zentralbl Chir,” Vol. 55, No. 4, 1928, p. 2382.

[16]   P. N. Blondeel, M. Hamdi, K. A. Sijpe Van de, K. H. Van Landuyt, F. E. Thiessen and S. J. Monstrey, “The Latero-Central Glandular Pedicle Technique for Breast Reduction,” British Journal of Plastic Surgery, Vol. 56, No. 4, 2003 348-359. doi:10.1016/S0007-1226(03)00191-7

[17]   L. Cardenas-Camarena and R. Vergara, “Reduction Mammaplasty with Superior-Lateral Dermoglandular Pedicle: Another Alternative,” Plastic and Reconstructive Surgery, Vol. 107, No.3, 2001, pp. 693-699. doi:10.1097/00006534-200103000-00007

[18]   A. D. Mandrekas, G. J. Zambacos and A. Anastasopoulos, “Hapsas DA. Reduction Mammaplasty with the Inferior Pedicle Technique: Early and Late Complications in 371 Patients,” British Journal of Plastic Surgery, Vol. 49, No. 7, 1996, pp. 442-446. doi:10.1016/S0007-1226(96)90027-2

[19]   U.S. Department of Health and Human Services, Healthy People, 2010.

[20]   H. Nakajima, N. Imanishi, S. Aiso, “Arterial Anatomy of the Nipple-Areola Complex,” Plastic and Reconstructive Surgery, Vol. 96, No. 4, 1995, pp. 843-845. doi:10.1097/00006534-199509001-00012

[21]   E. Wuringer, N. Mader, E. Posch and J. Holle, “Nerve and Vessel Supplying Ligamentous Suspension of the Mammary Gland,” Plastic and Reconstructive Surgery, Vol. 101, No. 6, 1998, pp. 1486-1493. doi:10.1097/00006534-199805000-00009

[22]   M. Keskin, Z. Tosun and N. Savaci, “Seventeen Years of Experience with Reduction Mammaplasty Avoiding a Vertical Scar,” Aesthetic Plastic Surgery, Vol. 32, No. 4, 2008, pp. 653-659. doi:10.1007/s00266-008-9167-1

[23]   R. Kuzbari and I. Schlenz, “Reduction Mammaplasty and Sensitivity of the Nipple-Areola Complex: Sensuality Versus Sexuality?” Ann Plast Surg, Vol. 58, No. 1, 2007, pp. 3-11. doi:10.1097/01.sap.0000250648.70177.4a

[24]   D. L. Abramson, S. Pap, S. Shifteh and S. B. Glasberg, “Improving Long-Term Breast Shape with the Medial Pedicle Wise Pattern Breast Reduction,” Plastic and Reconstructive Surgery, Vol. 115, No. 7, 2005, pp. 1937-1943. doi:10.1097/01.PRS.0000165085.23537.A7

[25]   N. I. Cruz and L. Korchin, “Lactational Performance after Breast Reduction with Different Pedicles,” Plastic and Reconstructive Surgery, Vol. 120, No. 1, 2007, pp. 35-40. doi:10.1097/01.prs.0000263371.37596.49

[26]   D. G. Pennington, “Improving the Results of Inferior Pedicle Breast Reduction Using Pedicle Suspension and Plication,” Aesthetic Plastic Surgery, Vol. 30, No. 4, 2006, pp. 390-394. doi:10.1007/s00266-006-0040-9

[27]   P. L. Tonnard, A. Verpaele and S. Gaia, “Optimising Results from Minimal Access Cranial Suspension Lifting (MACS-lift),” Aesthetic Plastic Surgery, Vol. 29, No. 4, 2005, pp. 213-220. doi:10.1007/s00266-005-0047-7