Septum-Based Mammaplasty: A Surgical Technique Based on Würingerʼs Septum for Breast Reduction

BACKGROUND: During the past 7 years, the senior author (M.H.) has been performing septum-based mammaplasty. The aim of this article is to report the safety and ease of breast shaping by using this technique. METHODS: A series of 110 consecutive patients underwent septum-based breast reduction performed by a single surgeon. This technique uses a lateral or medial pedicle based on Würinger's horizontal septum, which carries the main nerve supply to the nipple in addition to intercostal perforators. RESULTS: Mean nipple-to-sternal notch distance was 33 cm (range, 22 to 45 cm). Mean resection was 658 g (range, 160 to 1980 g). Nipple elevation was 9 cm on average (range, 3 to 17 cm). A retroareolar hematoma occurred in three breasts. Total areola necrosis occurred in one breast (0.5 percent) as a result of an infection in a diabetic patient. Limited wound dehiscence occurred in 15 breasts (7.7 percent). A secondary scar revision was needed in 10 patients (9 percent). One patient required a revision. CONCLUSIONS: Based on a well-vascularized and constant anatomical septum, a septum-based pedicle is safe, even in large breasts. This technique is safe and demonstrates ease of pedicle shaping and breast remodeling in patients undergoing reduction mammaplasty.