Comparison of vertical and inverted-T mammaplasties using photographic measurements.

BACKGROUND: Surgeons have long debated the relative merits of vertical and inverted-T mammaplasties. These debates have centered on surgeons' opinions. Without measurements, this controversy is unlikely to be resolved. This study compares these common techniques using a recently published measurement system. Such a study using measurements on photographs matched for size and orientation has not been previously published.

METHODS: A prospective group of women undergoing primary vertical mastopexies, augmentation/mastopexies, and reductions (n = 78) was compared with a retrospective group of women treated with inverted-T mastopexies, augmentation/mastopexies, and reductions (n = 35). Consecutive patients with photographs at least 3 months after surgery and no subsequent procedures were evaluated.

RESULTS: All patient groups demonstrated a significant elevation (P < 0.001) of the breast mound. Vertical mastopexy, but not inverted-T mastopexy, increased breast projection and upper pole projection (P < 0.008). Neither vertical nor inverted-T breast reduction significantly increased breast projection. Vertical breast reduction better preserved breast projection (P < 0.017) than the inverted-T technique. Vertical reduction significantly increased upper pole projection (P < 0.008), but inverted-T reduction did not. The inverted-T breast reduction caused greater breast constriction (reduced lower pole distance) than the vertical technique. Lower pole ratios were significantly higher for inverted-T patients (P < 0.01), indicating boxier lower poles.

CONCLUSIONS: Photographic measurements of relevant breast parameters favor the vertical technique over the inverted-T technique and are consistent with anatomical considerations and clinical experience.