To explore the application and clinical significance of the inverted-T pattern breast reduction in patients with breast hypertrophy, especially associated with breast cancer.

This retrospective study enrolled 39 patients with breast hypertrophy in Tongji Hospital and East Hospital Affiliated to Tongji University from October 2007 to October 2017. Those patients underwent inverted-T pattern breast reduction, including medial pedicle used in 25 patients, vertical pedicle in 5 and lateral pedicle in 9. Among 39 patients, there were 18 breast cancer patients, with the indication of breast conserving surgery, so they underwent both breast conserving surgery and inverted-T pattern breast reduction, in which medial pedicle was used in 10 patients, vertical pedicle in 4 and lateral pedicle in 4. The aesthetic effect was evaluated in 6 and 12 months after operation except 18 breast cancer patients who were evaluated after radiotherapy. The postoperative complications, recurrence, metastasis and patient satisfaction were observed.

All 39 patients were satisfied with natural and symmetrical postoperative appearance, obvious reduction and lifting of the breasts, normal blood supply and sensation of the nipple-areola area, and no obvious scar. One patient had necrosis of the nipple-areola area in one breast two weeks after operation, which healed after debridement and dressing change. Postoperative sensation decrease of bilateral nipple-areola areas occurred in five patients and it returned to normal after 6 months in four patients, 12 months in one patient. Postoperative local breast tissue induration was observed in five patients, including three breast cancer patients who received radiotherapy and presented no recurrence after removing the indurated lesions. Dog-ear deformity appeared in the surgical scar of three patients, and it was repaired by surgery under local anesthesia. Another three patients had slightly thickened scars, while the rest had normal scars. Three breast cancer patients developed skin edema after radiotherapy, which subsided 12 months after surgery. Postoperative aesthetic evaluation at 6 months after operation showed that excellent outcome was achieved in 25 cases, good in 10, moderate in 4, poor in 0 (in 18 cases of breast cancer, excellent aesthetic effect was achieved in 9 cases, good in 6, moderate in 3, poor in 0). Postoperative aesthetic evaluation at 12 months after operation showed that excellent aesthetic effect was achieved in 25 cases, good in 13, moderate in 1, poor in 0 (in 18 cases of breast cancer: excellent aesthetic effect was achieved in 9 cases, good in 8, moderate in 1, poor in 0). One patient with severe hypertrophy of both breasts was followed up for 10 years after operation, suggesting no significant change in the appearance of her breasts. All patients were followed up for 15-120 months (median 61 months). None of 18 breast cancer patients had local recurrence or metastasis.

For patients with breast hypertrophy, especially those who are diagnosed with breast cancer, inverted-T pattern breast reduction can remove the lesions, reduce hypertrophic breasts and accomplish the mammoplasty.