[Criss-cross dermis suspension in the treatment of breast hypertrophy].

AIM The results obtained with a technique using the dermis suspension associated with a central pedicled dermo-glandular-adipose flap, for the durable filling of the superior pole over time, are presented. METHODS Forty patients, affected by marked mammary hypertrophy, have been selected and divided into 2 groups (A, B) of 20 patients each. In both groups we have used a reduction mammaplasty technique based on a superior-medial dermo-glandular flap associated with a central pedicled dermo-glandular-adipose flap. In group B we have associated the preparation of the dermal brassiere crossed as a bra (criss-cross). In the follow-up of 15 months in average (range 8-24), we evaluated: the sensitiveness of the nipple-areola complex (NAC) using a visual analogic scale; the degree of mammary ptosis measuring the distance of the NAC from the jugulum and the distance between the areola and the submammary fold; the persistence of the filling of the superior pole, initially emptied, and the length of the scars. RESULTS The sensitiveness of the NAC in both groups was satisfactory in 72% (29/40) of the cases (P<0.001). The filling of the superior pole by a central pedicled dermo-glandular-adipose flap was satisfactory in both groups in the initial phase. The comparison between the 2 groups of patients showed, in the follow-up of 24 months, an areolar ptosis of 1.5 cm inferior in average (1 cm group A against 2.5 cm group B in average) and a marked decrease of the ptosis of the lower pole (P<0.001). CONCLUSIONS In the patients of group B the preparation of the dermal brassiere (criss-cross) led to an improvement of the stabilization of the form over time and a considerable decrease of the postoperative ptosis.