ABSTRACT
Breast reduction techniques have been described since the end of the nineteenth century, but it was Schwarzmann in 1930 who described the first nipple-areolar transposition on a medial pedicle; this was a major advance for breast reduction aesthetics, where blood supply for the nipple-areolar complex was preserved. Patients' co-morbidities must be considered when planning breast reduction, focusing on smoking history, body mass index, connective tissue diseases and use of immunosuppressants. Supero-medial pedicle reduction mammoplasty is, in our experience, a technique that offers easily reproducible, highly aesthetic results for breast reduction, while allowing excision of large volumes and weights of breast parenchyma. Breast reduction may be requested by the patient or advised by the clinician for a multitude of reasons to improve quality of life, rather than purely cosmetic motivations, some of the most common being chronic back, neck or shoulder pain, recurrent intertrigo at the infra-mammary fold or poor self-confidence related to macromastia.
