A Freiberg, MM Carr. Improving pseudoptosis in Robbins reduction mammaplasty. Can J Plast Surg 1994;2(2):71–74. The problem of the high nipple is frequently observed after reduction mammaplasty. Our hypothesis was that this deformity could be avoided with proper nipple-areolar complex (nac) placement. The original Robbins inferior pedicle reduction mammaplasty was modified by the placement of the nac intraoperatively at the completion of the breast mound construction. One hundred and fifty-three consecutive patients were followed after reduction mammaplasty. Pseudoptosis, defined as a nac above the inframammary fold while the breast tissue appeared to have descended, was graded as mild, moderate or severe. Individuals were classified by two independent observers. Frequency and degree of pseudoptosis in the original technique was significantly greater than in the modified group. In both groups there was no relationship between number of years postoperative or amount of breast excised and pseudoptosis. Incidence of pseudoptosis was related to breast type and possibly pregnancy in both groups. We conclude that pseudoptosis is likely a result of an initial improper nac placement as opposed to an expected result of reduction mammaplasty.
