Safety and efficacy of the double-unit superomedial central pedicle in vertical reduction mammaplasty: A retrospective cohort study.
4 affiliations
- 1Division of Plastic & Reconstructive Surgery, University of Florida, Gainesville, FL, USA.
- 2Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.
- 3Division of Plastic & Reconstructive Surgery, University of Colorado, Aurora, CO, USA.
- 4Department of General Surgery, University of Miami Hospital and Clinics, Miami, FL, USA.
Abstract
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. 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. 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 body surface area (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). The DUS pedicle combined with a vertical resection pattern, demonstrated a favorable safety profile while preserving the aesthetic advantages of a vertical reduction, 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.
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BibTeX
@article{applebaum2026safety,
title = {{Safety and efficacy of the double-unit superomedial central pedicle in vertical reduction mammaplasty: A retrospective cohort study.}},
author = {Sarah A Applebaum and Ryan J Sherry and Nhan Trieu and Armina Azizi and Kalyan Dadireddy},
journal = {JPRAS open},
year = {2026},
month = oct,
doi = {10.1016/j.jpra.2026.10.009},
url = {https://europepmc.org/article/MED/42997228},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Safety and efficacy of the double-unit superomedial central pedicle in vertical reduction mammaplasty: A retrospective cohort study.
AU - Sarah A Applebaum
AU - Ryan J Sherry
AU - Nhan Trieu
AU - Armina Azizi
AU - Kalyan Dadireddy
PY - 2026
DA - 2026/10/23
JO - JPRAS open
DO - 10.1016/j.jpra.2026.10.009
UR - https://europepmc.org/article/MED/42997228
AB - 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. 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. 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 body surface area (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). The DUS pedicle combined with a vertical resection pattern, demonstrated a favorable safety profile while preserving the aesthetic advantages of a vertical reduction, 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.
SN - 2352-5878
ER -