"Research led by Frank Lau MD Assistant Professor of Clinical Surgery at LSU Health New Orleans School of Medicine has found that longterm breast reduction outcomes can be improved by using techniques that minimally disrupt the lower breast suspensory ligaments. The paper The SternumNipple Distance is Double the NippleInframammary Fold Distance in Macromastia is published AheadofPrint online in the Annals of Plastic Surgery.  Breast reduction is one of the most commonly performed plastic surgery procedures. The longterm appearance after reduction is not optimized  of the time using standard reduction techniques notes lead author Dr. Frank Lau. At LSU Health New Orleans we offer an improved technique that preserves more of the critical breast anatomy. This study provides an anatomical foundation for why our technique may yield better longerlasting results.  About  of patients who undergo the most commonly used breast reduction technique experience pseudoptosis or bottoming out as a longterm complication. This occurs when breast tissue drops to the lower portion of the breast independent of nipple position.  We want our patients to have a longlasting aesthetically pleasing breast shape says Lau.  Believing that disruption of the lower suspensory ligaments may be a critical factor because they are stronger than the upper sensory ligaments the researchers conducted a retrospective review of  patients who underwent breast reduction surgery from  studying the results in  individual breasts. In all patients only one reduction technique was performed per patient. Ninetytwo percent of the  reductions performed with the inferior pedicle technique used a Wise pattern incision which disrupts the lower suspensory ligaments and . used a Boston modification of Robertson technique which preserves the lower suspensory ligaments. Of the  superomedial pedicle reductions  . used a Wise pattern incision and  . used a vertical pattern incision.  By measuring the sternal notchnipple distance and the nippleinframammary fold distance  proxies for upper and lower sensory ligament strength respectively the study found a differential rate of stretch  for every  cm in upper sensory ligament stretch the lower sensory ligament length increases by . cm. This relationship strengthens the researchers hypothesis that the lower pole ligaments stretch at a significantly slower rate than the upper pole ligaments. An anatomic basis for this differential may exist. A horizontal membrane of dense connective tissue originating at the level of the fifth rib that divides the breast into segments at the level of the nipple has been described. This division may signify a transition point in sensory ligament strength. On that basis the authors recommend that techniques such as the Boston modification of Robertson technique should be preferred by surgeons seeking to avoid pseudoptosis. Other advantages of the Boston modification of Robertson technique include decreased operative time and elimination of the triple point the most common site of postoperative incision rupture.  This study is one of the largest breast anthropometry measurement studies ever performed says Lau. These results help us provide the best breast reduction outcomes to our patients.   Coauthors include Thomas Steele a thyear medical student at LSU Health New Orleans School of Medicine and Julian Pribaz MD of Brigham and Womens Hospital Harvard Medical School.  LSU Health Sciences Center New Orleans educates Louisianas health care professionals. The states most comprehensive health sciences university LSU Health New Orleans includes a School of Medicine the states only School of Dentistry Louisianas only public School of Public Health and Schools of Allied Health Professions Nursing and Graduate Studies. LSU Health New Orleans faculty take care of patients in public and private hospitals and clinics throughout the region. In the vanguard of biosciences research in a number of areas in a worldwide arena the LSU Health New Orleans research enterprise generates jobs and enormous economic impact. LSU Health New Orleans faculty have made lifesaving discoveries and continue to work to prevent advance treatment or cure disease. To learn more visit http http or http"