Modification of the Superomedial Pedicle in Wise-Pattern Breast Reduction: New Sling Suspension Technique to Prevent (Pseudo) Ptosis

The combination of the superomedial pedicle with the traditional Wise-pattern skin resection has gained increasing popularity for its versatility and ability to achieve significant reduction of breast parenchyma and skin envelope. 

The author describes a reproducible new dermal suspension technique for cranial stabilization and fixation of the superomedial pedicle in Wise inverted T breast reductions to prevent pseudoptosis.

One patient had a small dermal skin abscess caudal from the right areola as a tissue reaction on the remaining suture. The other peri- and post-operative cases were uncomplicated. Two patients experienced a two-week postoperative pain in the areas treated by liposuction. There was no reduced or increased sensibility of the nipple-areola complex. No signs of (pseudo) ptosis were seen. There was a 100% patient satisfaction rate. 

Our technique denoted to a direct support of the pedicle using a non-interrupted dermal suspension flap continued with the pedicle to be a medial, caudal and lateral support for the pedicle. The dermal sling reduced the anterior force generated by the pedicle. The pedicle enfolded by the dermal flap formed a vital basis for ingrowth in the surrounding tissue.