Benefits and pitfalls of vertical scar breast reduction

A quality assurance study was undertaken three years after beginning the vertical scar breast reduction technique. We examined the rate of early and late complications (major and minor) and compared these to the formerly used inverted-T scar and L scar breast reduction techniques. Inverted-T scar breast reductions have an early complication rate of up to 20% and a late complication rate of 20–30%. Our vertical scar breast reduction is a modified Lassus technique, incorporating a geometrically based and measurable preoperative marking of the breast, a superior pedicle, a central breast resection, an intraoperative positioning of the nipple-areola complex, and occasionally a periareolar skin resection. In the time span examined (September 1998–December 2001) 153 patients could be included in the study. The resection weight per breast ranged from 60 to 1262 g (mean 390±210 g, median 380 g). The early complication rate (hematoma, seroma, wound dehiscence, wound infection and necrosis) was 21.6%. Of these cases, 19.6% were minor complications. The late complication or imperfection rate was evaluated very strictly using the standardized, extended scheme of Ferreira (problems of volume, shape, symmetry, areola, scars and position of the breast on the thorax) and was 26%. Major late complications necessitating a reoperation occurred in 11.1% of cases. These complication rates compare well to those of other vertical breast reduction techniques and T scar reductions in our own clinic and in the literature. Given that the vertical scar breast reduction method also results in shorter scars and a significantly better, long-lasting breast projection, this technique is clearly justified to remain the standard method at our clinic.