ABSTRACT
BACKGROUND: Symptomatic breast hypertrophy affects the quality of life of a large number of women globally. Many reduction mammoplasty techniques have been described for patients with breast hypertrophy. The aim of this study was to provide our clinic's experience in utilizing the modified superomedial pedicle breast reduction technique in specific patients suffering from breast hypertrophy, with sternal notch-to-nipple distance of more than 33 cm. METHOD: Our study included twenty patients who underwent, from January 2022 to December 2023, the modified superomedial pedicle breast reduction technique due to symptomatic breast hypertrophy with sternal notch-to-nipple distance of more than 33 cm in the Plastic and Reconstructive Surgery Department at Nicosia General Hospital in Cyprus. Patient demographics, comorbidities, pre- and postoperative breast anthropometric measurements and surgical complications were recorded and analyzed. RESULTS: The average age at the time of the reduction was 48 years. The mean preoperative body mass index was 28.52 kg/m2. Patients' comorbidities included one (5%) patient with diabetes, seven (35%) with obesity and three (15%) with hypertension. The mean preoperative sternal notch-to-nipple distance was 35.25 cm for the right breast and 34.90 cm for the left breast, while the mean postoperative was 20.65 cm for both breasts. The total mean resection weight of both breasts was 1643.45 g. Surgical complications were minor including two (10%) cases of local hematoma and one (5%) case of T-Junction wound breakdown. All patients were relieved from their preoperative symptoms and were satisfied with the final result. CONCLUSION: Our modified superomedial pedicle technique is a safe, effective and versatile pedicle to be used with many advantages, in specific patients suffering from breast hypertrophy with sternal notch-to-nipple distance of more than 33 cm, including its shape and rotational abilities, viability of the nipple and excellent outcome of glandular plication and breast reshaping. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
ABSTRACT
Stahl's ear deformity is a congenital auricular anomaly characterized by a third crus in the auricular cartilage, giving rise to an irregular helical rim and a bent scaphoid fossa. This deformity is mainly treated surgically during childhood. However, studies regarding ear-molding techniques show that postpartum splinting offers a safer and more effective permanent correction, and that happens because of the high circulating levels of estrogen that neonates receive from their mothers right after birth, making the cartilage more malleable. We present a case that shows a newborn with unilateral Stahl's ear deformity, in which we used a molding device (EarBuddies) to permanently correct the ear's shape. After 3 weeks of treatment, the affected auricle regained its normal appearance. There were no complications. Long-term follow-up showed no recurrence. Splinting of this ear deformity seems to be a nonpainful, stress-free and, most importantly, effective nonoperative treatment. Postpartum clinical examination of the ears is crucial, as the sooner the nonsurgical correction of the deformity begins, the better the results are. A clinical screening for ear deformities should be established immediately after every child's birth to eliminate the risk for surgical intervention later in childhood.