Breast Reduction: 33 Years Using a Single Central Block.

[BACKGROUND] Since 1985, the author has been using the single central block technique for breast reduction and mastopexy, prioritizing the good relation between the final breast shape and the length of the scars, different from other authors who emphasize only the shape of the breast (Peixoto in Plast Reconstr Surg 65(2):217-225, 1980; Aesthet Plast Surg 8:231-236, 1984) and others who have drawn attention to the length of the scars (Arié in Rev Latinoam Cir Plast 3:23-31, 1957; Bozola in Plast Reconstr Surg 85:728-738, 1990; Sepúlveda in Rev Bras Cir 71(1):11-18, 1981). In this study, the author describes the use of a single central block of the mammary tissue and the nipple-areolar complex (NAC), dissected from the skin flaps and based on the superior vascular pedicle for reduction mammoplasty and mastopexy (Erfon et al. in Annals of the international symposium recent advances in plastic surgery, São Paulo, 1989; Hinderer (ed) Plastic surgery, Elsevier, Madrid, 1992; Proceedings of the 65th annual scientific meeting of the American society of plastic and reconstructive surgeons, Dallas, 1996).

[METHODS] A retrospective study was performed, evaluating patients who underwent breast reduction and mastopexy using the single central block technique from July 1985 to December 2018 by a senior author.

[RESULTS] A total of 2097 procedures were performed using this technique, 1556 being reduction mammoplasties and 541 mastopexies. The mean patient age was 44, and the mean weight of tissue resected was 455 g. Fat necrosis on the distal area of the flap was observed in 47 cases (2.24%). Hematoma was observed in 6 patients (0.28%). Surgical revisions were undertaken in 75 patients (3.57%). Hypertrophic scars occurred in 12 of the cases (0.57%). Dehiscence in the inverted "T" scars occurred in 78 of the surgeries (3.71%).

[CONCLUSIONS] This technique allows the surgeon to easily form a good cone shape of the breast, repositioning the NAC and preserving its vascularization and sensation without tension on the skin flaps sutures, resulting in smaller and better scars.

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