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Reliability and Versatility of the Wise Pattern, Medial Pedicle for Breast Reduction in South Africa

24 Pages Posted: 11 Jun 2019 Publication Status: Under Review

See all articles by Letlhogonolo Brian Andrew Monaisa

Letlhogonolo Brian Andrew Monaisa

Chris Hani Baragwanath Academic Hospital - Department of Plastic and Reconstruction Surgery

Elias Ndobe

University of the Witwatersrand - Department of Plastic and Reconstruction Surgery

Aylwyn Mannell

University of the Witwatersrand - Department of General Surgery

Marietha Nel

University of the Witwatersrand - Department of General Surgery

Abstract

Background: Breast hypertrophy is a condition of abnormal enlargement of the breast which may continue until each breast weighs over 1.5kg (macromastia) or even over 2kg (gigantomastia). Supporting such heavy weights leads to cervical and upper thoracic backpain, costochondritis and fungal infections in the mammary folds, making reduction mammoplasty essential. However, there is a lack of consensus among plastic surgeons as to the best technique. This study reports the results of reduction mammoplasties in South African women using the Wise pattern, minimally undermined with a medial pedicle.

Methods: A retrospective record review of the reduction mammoplasties was conducted over a one year period. Patient records were assessed for early complications related to vascular reliability.

Results: One hundred and fourteen Wise pattern minimally undermined, medial pedicle techniques were performed on 57 patients in the one year period at the NetCare Rand Clinic in Berea, Johannesburg, South Africa (EN). The patients’ sternal notch to nipple distances ranged from 28 to 52cm. The volume of breast reduction ranged from 345g to 3300g per breast. The overall complication rate was 9.7%, consisting of fat necrosis (3.5%), infection(1.7%), dehiscence (3.5%), and nipple epidermolysis (0.9%).

Conclusion: The minimally undermined Wise pattern medial pedicle breast reduction technique proved to be a reliable technique for breast reduction in the South African population. Safety in pedicle breast reduction with sternal notch to nipple distances of up to50cm, as well as reliability and versatility in a wide range of breast sizes were demonstrated.

Keywords: Mammary hyperplasia, Reliability, Versatility, Wise pattern, Minimally undermined, Medial pedicle

Suggested Citation

Monaisa, Letlhogonolo Brian Andrew and Ndobe, Elias and Mannell, Aylwyn and Nel, Marietha, Reliability and Versatility of the Wise Pattern, Medial Pedicle for Breast Reduction in South Africa (June 10, 2019). Available at SSRN: https://ssrn.com/abstract=3402091 or http://dx.doi.org/10.2139/ssrn.3402091

Letlhogonolo Brian Andrew Monaisa

Chris Hani Baragwanath Academic Hospital - Department of Plastic and Reconstruction Surgery

South Africa

Elias Ndobe

University of the Witwatersrand - Department of Plastic and Reconstruction Surgery

South Africa

Aylwyn Mannell

University of the Witwatersrand - Department of General Surgery

South Africa

Marietha Nel (Contact Author)

University of the Witwatersrand - Department of General Surgery ( email )

South Africa

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