Safety and Outcomes in Rereduction Mammaplasty: Single Institution Experience and Review of the Literature.

BACKGROUND: Reduction mammaplasty is commonly performed for symptomatic macromastia and is useful in achieving symmetry in unilateral breast reconstruction and oncoplastic surgery. Postoperatively, however, recurrent macromastia or asymmetry often develops. In the past, there has been concern about safely resecting additional volume and moving the nipple. We analyze our outcomes with regard to rereduction mammaplasty, (and discuss) these results in comparison to the current literature.
METHODS: A retrospective review of patients undergoing rereduction mammaplasty at Emory Hospital from 2008 to 2014 was performed. Prior breast reduction and subsequent removal of additional tissue was required for inclusion. Patient demographics, pedicle selection, time from initial to rereduction, reduction weight, indications, and complications were recorded.
RESULTS: Our review identified 37 patients who underwent rereduction mammaplasty. Thirty-four underwent unilateral and 3 underwent bilateral reduction. Average initial reduction weight was 483 g, and average rereduction weight was 226 g. Thirty reductions required nipple areolar complex repositioning; 25 used a superior pedicle, and 5 used a central mound. Eighty-three percent of the superior pedicle and 20% of the central mound reductions used the same pedicle. There were 5 complications reported; no cases of nipple necrosis were reported.
CONCLUSIONS: With careful technique, rereduction mammaplasty is safe, reliable, and effective. Varying amounts of tissue may be excised, and the nipple may be moved safely with a short superior or central mound pedicle regardless of initial technique. Limited rereduction can be performed as early as 4 to 6 months.