Work

Safety and efficacy of the double-unit superomedial central pedicle in vertical reduction mammaplasty: A retrospective cohort study

Year: 2026

Type: article

Abstract: Background Reduction mammaplasty relieves macromastia symptoms and improves aesthetics. Traditional pedicles offer reliable vascularity for most patients, but their reliability is often limited by resection weight and notch-to-nipple or nipple-to-inframammary fold (N-IMF) distances. The double-unit superomedial central (DUS) pedicle, paired with a vertical resection pattern, was developed to improve vascular reliability and projection across a broader range of patients, irrespective of above mentioned limitations. Methods A retrospective review included all consecutive patients undergoing bilateral vertical reduction mammaplasty with the DUS pedicle by a single surgeon at the University of Florida (January 2021-December 2023). Demographic, anatomic, and outcome data were compared between patients with <500 g and ≥500 g resections (based on smaller-breast resection weight) using Welch's t-test and Fisher's exact test. Results Sixty-three patients (mean age 35.1 ± 16.0 years) were included; most had grade III ptosis (65%) and sternal notch-to-nipple distance ≤37 cm (89%). Thirty-nine patients underwent <500 g resections and 24 underwent ≥500 g resections. Compared with the <500 g cohort, patients undergoing ≥500 g resections had higher BSA, longer operative times, more advanced ptosis, and longer sternal notch-to-nipple distances. Eleven complications (11/63, 17%) occurred, including eight minor and three major (3/63, 4.8%), with no significant difference in overall complication rates between resection groups (25% vs. 13%; p =0.307). Conclusion The DUS pedicle combined with a vertical resection pattern, demonstrated a favorable safety profile while preserving the aesthetic advantages of a vertical scar, even in patients with advanced ptosis and larger resection volumes, without evident compromise in outcomes. These findings support the safety and feasibility of this approach and warrant prospective validation.

Source: JPRAS Open

DOI: 10.1016/j.jpra.2026.10.009

Authors: Sarah A. Applebaum, Ryan J. Sherry, Nhan Trieu, Armina Azizi, Kalyan Dadireddy

Institutions: University of Florida Health, University of Florida, Oklahoma State University Center for Health Sciences, University of Colorado Anschutz, University of Miami Hospital

Language: English

Topic: Breast Implant and Reconstruction

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,920