analysis of the long term results of the four different techniques with a new method in the patients who were performed reduction mammaplasty

SUMMARYReduction mammaplasty is one of the most common operations among the plasticsurgery procedures that needs an exact experience and professionality. It seems that muchmore as an aesthetic procedure, it is a reconstructive operation basicly Basic targets ofreduction mammaplasty are providing the desired reduction and shape with minimal scar byprotecting the breast feeding and the sensitivity and also protecting the shape and preventingof recurren pitosis in long term.In our study we compared Graf, Inferior, Lejoure and McKissock techniques forproviding the basic principles above mentioned. We improved a photographic analysis metodthat measuring and evaluating objectively the changes in these technique in mean 2.5 yearsfollow up. In this metod mid-clavicula-nipple (CN) and sternal notch-nipple(SN) distancesmeasured and than taken photographs of early postoperatively (postoperatively 1-6 months)and late postoperatively(postoperatively1-5 years) rutinly by a digital photograph machinefrom a distance of 1.5 m preoperatively.In this study photographs were examined on computer using Adobe Photoshop CS(Adobe Systems, Inc., San Jose, CA) programme for the purpose of to see and evaluate thechanges between measurements objectively. After providing the appropriate calibration forthe real measurements, firstly preoperative and early postoperative photos collide on eachother, decreasing the opacity of the upper photo, then changes evaluated objectively. Nippletranspozition distance(NTD), CN and SN were measured. The same procedure andmeasurements were done on the early postop and late postop photos.88In our study we evaluate these four technique between each other clinically andstatistically. Graf technique is the most stabil technic for the long term for statistical analysisof the measurements. Then comes Inferior and Lejoure techniques. The most unstabiltechnique is the McKissock technique and then comes Lejoure technique. Scar ratio is higherin the McKissock and Inferior technique than Graf and Lejoure technique. Sense of themamma is protected beter by Graf technique and Inferior technique. Ratio of ptosis and NTDis higher in Lejoure technique than Graf technique but it is smaller than McKissock andInferior technique. Graf technique is suitable for the redüctions that are aproximately 400 g.However Lejoure technique is suitable for the cases that will excited aproximately 800 g.Pseudoptozis deformity is seen most frequently in McKissock technique. But its mostimportant advantage is possibilityof extensive resections and preoperative easy planning. As aresult we suggest Graf technique for the small and medium mammas, Inferior technique forthe big mammas.The analysis metod we presented, can compare the postoperative changes and minimalscars in patients with milimetric sensitivity.Keywords: Reduction mammaplasty, photogrphic analysis89