Mert Ersan, Hilal Aybüke Yıldız
European Journal of Breast Health - 2026;22(1):72-77
Objective: The superomedial pedicle technique combines aesthetic advantages with reliable vascularity in reduction mammaplasty. This study evaluated the safety and clinical outcomes of Doppler ultrasonography-guided identification of the superior perforator in the superomedial pedicle design. Materials and Methods: This retrospective study included 22 female patients who underwent bilateral superomedial pedicle reduction mammaplasty between April 2023 and April 2025. In all patients, the superior perforator was detected preoperatively using a portable handheld Doppler ultrasonography device and was incorporated into the pedicle design. All patients underwent surgery via an inverted-T pattern with the superomedial pedicle. The mean follow-up period was 1.2 years. Results: The superior perforator was identified in all patients (mean time: 3.0+/-0.4 minutes). No partial or total necrosis of the nipple-areola complex was observed in any patient. Wound dehiscence occurred at the T-incision site in four patients, transient areolar hypoesthesia was observed in three patients, and hypertrophic scarring developed in one patient. Aesthetic outcomes were evaluated in all patients by physical examination and standardized photography. Conclusion: Detection of the superior perforator with Doppler ultrasonography enables individualized planning of the superomedial pedicle and enhances vascular safety. This approach provides a feasible, individualized, and reliable surgical technique for reduction mammaplasty, thereby reducing complication rates.
