Curtain type combined pedicled reduction mammoplasty with internal suspension for extensive hypertrophic and ptotic breasts.

Correction of extensive hypertrophy and ptosis of the breast with a long distance between the jugular notch of the sternum and the nipple presents a number of surgical challenges: Maintaining adequate nipple-areola perfusion, preserving sensation and function, minimising scars, and forming a juvenile breast shape. The curtain type bipedicled mammoplasty with internal suspension combines the following procedures: the surface of the new breast is built entirely by a cranially based flap, thus avoiding a vertical scar and stabilising the periareolar wound. The nipple-areola is pedicled caudally as well as centrally, thus optimizing perfusion and maintaining sensation and the capacity for lactation. Fixing of deepithelialized skin stabilises the residual breast tissue at the thoracic wall and forms an internal suspension.