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Superomedial pedicle–based reduction mammoplasty using a Wise-pattern skin resection is a well-established technique for breast reduction. However, long-term data on morphometric changes—such as nipple position shifts and lower pole expansion—remain limited. This study evaluated postoperative morphometric changes and their predictors at 3, 6, and 12 months after surgery, compared with intraoperative planning measurements.

A retrospective cohort and correlational study was conducted of 100 female patients (>= 17 years) who underwent primary bilateral reduction mammoplasty using a superomedial pedicle and Wise-pattern. Pre- and postoperative data included demographics, comorbidities, resection weights, 3D volumetric assessments, and anthropometric measurements: midclavicle-to-nipple distance (MCN), lower areolar border–to–inframammary fold distance (IMFA), and areolar diameter (DA). Complications were graded according to the Clavien–Dindo classification. Generalized linear and logistic regression models were used to assess associations between patient- and surgery-related variables and postoperative outcomes.

The median age was 39.5 years. Mean resection weights were 430 g (right) and 450 g (left), with 54% of cases ranging between 200 and 499 g. Median postoperative breast volumes were 630 cc at 3 months, 536 cc at 6 months, and 605 cc at 12 months. Minor complications (grade I) occurred in 15% of patients, and one grade IIIb event required reoperation. At 12 months, minimal nipple descent was observed (mean MCN increase of 1.01 cm), along with mild lower pole expansion (mean IMFA increase of 1.27 cm) and a slight increase in areolar diameter (0.25 cm). Higher postoperative breast volume was associated with greater morphometric changes, whereas larger resection weights (500–2000 g) and higher BMI predicted increased lower pole expansion.

Postoperative morphometric changes were significantly associated with breast volume, resection weight, age, and BMI, underscoring the importance of individualized surgical planning and long-term follow-up to optimize aesthetic outcomes.

The goal of breast reduction surgery is to achieve a beautiful breast shape with minimal scarring. The advantage of vertical scar mammaplasty is less scarring, but it can be applied to medium-sized breasts. The purpose of this study is to describe and review the lollipot scar breast reduction technique. With this technique, it is possible to obtain less scarring and a more natural breast shape compared to reverse T breast reduction mammaplasty techniques.

A retrospective review of this procedure was performed for 106 breast reductions. Patients were aged 17 to 61 years (mean 37.82 years). The mean follow-up period was 9,9 months (range 3-36 months).
In breast reduction surgeries, raising the IMF higher is not really possible with reverse T techniques; the old IMF is generally used. However, in the LtSM technique, the old IMF is completely obliterated and a new IMF is re-formed higher up. This significantly reduces the amount of skin that needs to be excised horizontally. As a result, no incision is required along the inframammary fold. Furthermore, the medial and lateral borders of the breast are formed by natural folds, eliminating the need for an incision line and thus preventing scarring.

Superomedial pedicle was used in 76 patients, superior pedicle in 16 patients, superolateral pedicle in 7 patients, and different pedicles in 7 patients. An average of 595,76 g tissue (range 120–1,590 g) was excised from the right breast. An average of 593,23 g tissue (range 122–1,600 g) was excised from the left breast. The right nipple was elevated an average of 7,15 cm (range 3–14,3 cm). The left nipple was elevated an average of 7,04 cm (range 2,6–13 cm). The pillar length was used as an average of 4,86 cm (range 4,5 - 5,5 cm). The lollipot horizontal scar length was measured as an average of 5,85 cm (range 1,3 - 14 cm) for the right side and an average of 5,81 cm (range 1,1 - 12,5 cm) for the left side. In the controls, the average lollipot scar horizontal length was 5,61 cm (range 1,3–13 cm) on the right side and 5,57 cm (range 1–11,5 cm) on the left side. The average follow-up period was 9,9 months (range 3–36 months).

I conclude that the lollipot scar breast reduction technique can effectively be used in the treatment of almost all types of breast sizes and has consistently produced good breast shape, and that leaves less scarring than reverse T breast reductions.

To introduce and evaluate an original author’s technique of mastopexy involving three-segment fixation of the lower-septal pedicle — the Trefoil Technique .

We operated on 108 patients aged 18 to 55 years with Regnault grade II–III breast ptosis from 2020 to 2024 according to the reported technique. The upper edge of the inferior-septal pedicle was vertically divided into three equal segments. Depending on the degree of ptosis, absorbable sutures were used to fix the segments to the pectoral fascia at 10, 12, and 2 o’clock:
• anterior edge for grade III ptosis,
• posterior edge for grade II-III,
• inner surface of the pedicle for grade II.
Patients were followed up for 12-18 months.

No areolar necrosis or persistent sensory loss was observed. Minor T-junction healing delay occurred in 2.6% of cases, managed conservatively. In 96% of patients, stable upper pole fullness and optimal areolar centralization were achieved. Upper pole projection demonstrated greater long-term stability than that observed in standard inferior pedicle-based mastopexies.

The Trefoil technique is a novel mastopexy method that provides durable breast shape and consistent upper pole fullness through anatomical tissue repositioning and multi-point fixation. It offers reliable outcomes with minimal complications and preserves both nipple vascularity and sensitivity. This technique serves as a strong, implant-free alternative to traditional inferior pedicle mastopexy.

Achieving breast symmetry represents a critical endpoint in reduction mammoplasty. Historically, surgeons have been predominantly depended on anthropometric parameters, such as linear measurements and tactile evaluation, to guide intraoperative decision-making. Nonetheless, there remains a substantial unmet need for objective, intraoperative volumetric assessment techniques. While 3-dimensional volumetric analyses have become well-established tools for preoperative planning and postoperative evaluation, the literature on intraoperative volumetric assessment is still quite limited and relies on scanning devices lacking rigorous validation.

We analyzed 100 patients undergoing reduction mammoplasty with supero-medial pedicle and wise pattern skin resection. We compared volumetric differences of the last 50 reduction mammoplasty procedures before using intraoperative volumetric measurements (group A; control) to the first 50 reduction mammoplasties after implementation of intraoperative volumetric analysis using Vectra H2 3D photogrammetry (group B; intraoperative 3D). The follow-up period was 12 months.

Fifty patients were included in group A and 50 patients in group B. Patient demographics, mean resection weight, and complications
did not differ statistically significantly. The 3-month postoperative volumetric differences between the breasts of the same patient averaged
5.8% ± 3.0% (mean ± SD, 0.1%-12.2%) in Group A (control) and 2.9% ± 1.5% (mean ± SD, 0.8%-6.9%) in Group B (intraoperative 3D). These differences were statistically significant (P < .05).

In our study, intraoperative 3D photogrammetry for volumetric analysis significantly improved volumetric symmetry following reduction mammoplasty. Although the volumetric differences in both groups were relatively small, the technique facilitated the intraoperative identification of outliers and resulted in superior volumetric symmetry.

Patient demand for breast reduction has increased 54% in recent years, driven by physical symptom relief and psychosocial benefits. As patients increasingly use social media for health information, search terminology may function as an exposure filter determining whether patients encounter peer narratives or provider-directed education before consultation. This study evaluated whether lay versus technical search terminology retrieves distinct content profiles and engagement patterns on TikTok.

A cross-sectional analysis of public TikTok posts was performed in January 2026. Four terms were queried: "breast reduction," "boob reduction," "reduction mammaplasty," and "gigantomastia surgery." The top 15 most-liked posts per term from the preceding 6 months were analyzed (n=60). Variables included creator type, content category, video length, views, likes, comments, shares, and follower count. Engagement (sum of likes, comments, and shares) was compared across terms using nonparametric testing with Bonferroni correction. Thematic analysis of captions and top comments was conducted.

"Breast reduction" yielded exclusively patient-generated posts (15/15), while "reduction mammaplasty" had the highest proportion of provider-generated posts (8/15); "boob reduction" and "gigantomastia surgery" each had 2/15. Educational content appeared in 3/15 posts for "boob reduction," "reduction mammaplasty," and "gigantomastia surgery," and 0/15 for "breast reduction." Posts retrieved via "breast reduction" demonstrated higher engagement than "reduction mammaplasty" (median 258,088 vs. 4,896; p=0.0007), as did "boob reduction" (median 55,149 vs. 4,896; p=0.003). "Breast reduction" videos were shorter than "reduction mammaplasty" videos (p<0.0001). Satisfaction with surgical outcomes appeared in 60% of captions overall, and was more common with the lay term (14/15) than the clinical term (3/15).

The term "breast reduction" yielded exclusively patient-generated, shorter, experience-focused content, whereas "reduction mammaplasty" yielded predominantly provider-generated educational and promotional posts. Patients using common lay terms are therefore more likely to encounter peer narratives before formal medical education. These findings underscore the importance of addressing expectations shaped by patient-generated content and incorporating lay terminology into patient-facing outreach.

To report an extreme case of juvenile gigantomastia in an adolescent and to highlight the surgical challenges and outcomes of massive breast reduction using a free nipple-areola complex graft technique.

A 15-year-old girl presented with progressive bilateral breast enlargement over two years, associated with severe functional limitation and psychological distress. Clinical examination revealed massive breast hypertrophy with severe ptosis and a sternal notch-to-nipple distance >= 45 cm. Bilateral reduction mammoplasty using the Thorek technique with free nipple-areola complex grafting was performed.

A total of 16.5 kg of breast tissue (27% of body weight) was removed. The postoperative course was complicated by hypovolemic shock requiring blood transfusion and intensive care monitoring. Partial nipple-areola complex necrosis occurred and was managed with delayed reconstruction using a full-thickness skin graft. At 8-month follow-up, the patient showed complete resolution of pain, improved mobility, and a satisfactory aesthetic outcome.

Extreme juvenile gigantomastia is a rare and challenging condition. The Thorek technique represents a safe and effective option for massive breast reduction, although staged reconstruction may be required. Early surgical management significantly improves functional and psychological outcomes.

Post-radiation fibrosis and vascular compromise significantly complicate elective breast surgeries in previously irradiated patients, despite a high incidence of post-treatment asymmetry and macromastia. This study evaluates complication profiles across surgical techniques to provide evidence-based guidance for breast reduction and mastopexy in irradiated breasts.

A retrospective cohort of 41 patients with prior breast irradiation undergoing bilateral breast reduction (n=30), mastopexy (n=7), or mixed procedures (n=4) between 2015–2023 was analyzed. Reduction techniques included superior pedicle (n=4), supero-medial pedicle (n=12), and Thorek free nipple graft (n=14); mastopexies employed Wise-pattern superior pedicle techniques. Outcomes were compared with 1,442 non- irradiated breast reductions. Complications were classified as major (reoperation required) or minor (conservatively managed). Statistical analysis utilized Fisher’s exact tests and odds ratios (SPSS v26).

Irradiated breasts had significantly higher overall complication rates compared to non-irradiated controls (44% vs. 21%; OR 3.017; p=0.0014), with seromas occurring exclusively in irradiated cases (15% vs. 0%; p<0.001). Mastopexies showed higher dehiscence rates than reductions (29% vs. 0%; p=0.01). Among reduction techniques, the supero-medial pedicle had the highest complication rate (67%), while Thorek procedures showed no seromas (p=0.04). No major complications occurred; revisions (15%) addressed asymmetry only.

Breast surgery in irradiated fields remains viable when guided by technique-specific risk profiles and conservative tissue handling. Mastopexy carries elevated dehiscence risks, while the Thorek technique may reduce seroma formation in high-risk patients. Because subgroup analyses were under-powered, all technique-related recommendations should be regarded as preliminary and hypothesis-generating, pending validation in larger multicentre cohorts.

In this systematic review and meta-analysis, we evaluate the existing literature to quantify the rate of SD following breast augmentation, and quantitatively prove the association of previously documented risk factors.

A systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidance, with forest plot generation and heterogeneity assessment for each risk factor. A review protocol was prospectively registered on PROSPERO. The primary outcome was to identify the incidence rate of SD following breast augmentation. The secondary objective was to quantitatively prove the association between selected risk factors and the occurrence of postoperative breast striae. A comprehensive search strategy to capture all relevant articles related to the review question, in accordance with the Meta-analysis of Observational Studies (MOOSE) guidance

Inclusion criteria were as follows:

• Study types: Randomised controlled trials (RCTs), Non-randomised controlled trials, (NRCT), cohort studies, cross-sectional studies and case series of patient groups with documented occurrence of striae and appropriate comparison groups without striae.
• Participants: All patients who underwent primary breast augmentation
• Intervention: Primary breast augmentation
• Comparators: Absence of secondary risk factors
• Outcomes: Incidence of SD

Three studies that met the inclusion criteria underwent full data extraction and meta-analysis. The incidence of SD averaged at 4.92% across all three included studies. The mean SD presentation was 56.3 days post-surgery, ranging between 30 – 90 days.

Meta-analysis of three studies demonstrated statistically significant association between nulliparity and postoperative striae formation (pooled lnOR = 11.61; 95% CI 2.05–21.17; p = 0.017).
A prior history of SD emerged as the strongest risk factor for developing SD post augmentation. Meta-analysis demonstrated a statistically significant association (pooled lnOR = 3.51; 95% CI 1.58–5.44; p < 0.001).

SD is an uncommon yet morbid complication following breast augmentation and should be routinely addressed when obtaining consent. A prior history of SD and nulliparity may represent additional risk factors and should be considered during preoperative assessment and counselling, especially given the lack of effective therapies

Achieving good aesthetic outcomes in ptotic breast reconstruction requires a form of skin reducing mastectomy or a mastopexy pattern. In this case series, we report the outcomes of our modified vertical mastopexy pattern (VMP), focusing on complication rates and satisfaction rates using BREAST-Q PROMs.

A total of 69 patients who underwent modified (VMP) and immediate autologous breast reconstruction (IABR) from January 2023 to August 2025 were reviewed. Outcomes were described using descriptive statistics. The BREAST-Q survey was collected at 6 months post-surgery, retrieved from the United Kingdom National Flap Registry. Complications were described according to the Clavien–Dindo classification.

A total of 69 patients (15 bilateral and 54 unilateral) with 84 breasts underwent MVM with IABR. In this series, 85 flaps were harvested for breast reconstruction. 88.2% (75/85) of breast reconstructions were performed using a DIEP flap, 2.4% (2/85) with a type 2 muscle-sparing TRAM flap, and 9.4% (8/85) with a TUG flap, two of which were used in a stacked configuration. 13.3% (10/75) DIEP flaps and one 1.7% (1/6) TUG flaps were bipedicled, respectively. The average flap harvested weight was 622.2 g per breast, with a mean mastectomy weight of 526 g per breast. All unilateral reconstruction cases had simultaneous contralateral mastopexy using the same pattern. The mean nipple transposition was 5 cm and 5.84 cm for the mastectomy breast and contralateral mastopexy, respectively. The survey achieved a 70% (48/69) response rate. The BREAST-Q satisfaction with breasts scored an average of 86.7% (55.5/64), and satisfaction with outcome scored 90.2% (43.3/48). Forty-five percent (38/84) of breasts had grade 1 and 2 complications, which required minor to no intervention. A total of 11.9% (10/84) of breasts had grade 3 complications; four (5.8%; 4/69) patients required an immediate return to the operating theatre postoperatively, and there were no flap losses.

This technique is easily reproducible and allows for aesthetically pleasing outcome of IABR. It allows for simultaneous symmetrising mastopexy with the same pattern. It produced superior patient satisfaction with minimal complications, mainly superficial epidermolysis or partial skin necrosis, that were managed conservatively.