{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T23:28:39Z","timestamp":1750116519911},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2020,3,16]],"date-time":"2020-03-16T00:00:00Z","timestamp":1584316800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Breast reduction for extreme macromastia in obese patients is a potentially high-risk endeavor. Free nipple grafting as well as a variety of pedicled techniques have been advocated for large reductions in obese patients, but the number of different approaches suggests that no single method is ideal. This paper suggests the Robertson Mammaplasty, an inferior pedicle technique characterized by a curvilinear skin extension onto the pedicle, as a potentially favorable approach to this clinical situation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The author sought to determine the safety of the Pedicled Robertson Mammaplasty for extreme macromastia in obese patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The records of a single surgeon\u2019s practice over a 15-year period were retrospectively reviewed. Inclusion criteria were a Robertson Mammaplasty performed with a &amp;gt;3000-g total resection and a patient weight at least 20% above ideal body weight. Records were reviewed for patient characteristics, operative times, and complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The review yielded 34 bilateral reduction patients that met inclusion criteria. The mean resection weight was 1859.2 g per breast, the mean body mass index was 36.4 kg\/m2, and the mean sternal notch-to-nipple distance was 41.4 cm. Mean operative time was 122 minutes. There were no cases of nipple necrosis and no major complications that required reoperation under general anesthesia. A total 26.4% of patients had minor complications that required either local wound care or small office procedures, and 4.4% received small revisions under local anesthesia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The Pedicled Robertson Mammaplasty is a fast and safe operation that yields good aesthetic results and a relative minimum of complications in the high-risk group of obese patients with extreme macromastia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of Evidence: 4<\/jats:title>\n                  <jats:p \/>\n               <\/jats:sec>","DOI":"10.1093\/asj\/sjaa073","type":"journal-article","created":{"date-parts":[[2020,3,16]],"date-time":"2020-03-16T04:57:31Z","timestamp":1584334651000},"page":"NP666-NP675","source":"Crossref","is-referenced-by-count":1,"title":["The Pedicled Robertson Mammaplasty: Minimization of Complications in Obese Patients With Extreme Macromastia"],"prefix":"10.1093","volume":"40","author":[{"given":"Richard J","family":"Restifo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,3,16]]},"reference":[{"issue":"4","key":"2022120220531984600_CIT0001","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1097\/00000637-199510000-00001","article-title":"Reduction mammaplasty: an outcome analysis","volume":"35","author":"Dabbah","year":"1995","journal-title":"Ann Plast Surg"},{"issue":"6","key":"2022120220531984600_CIT0002","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1097\/01.PRS.0000160695.33457.DB","article-title":"Analysis of breast reduction complications derived from the BRAVO study","volume":"115","author":"Cunningham","year":"2005","journal-title":"Plast Reconstr Surg"},{"issue":"5","key":"2022120220531984600_CIT0003","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1097\/00006534-200010000-00006","article-title":"Relationship of obesity and specimen weight to complications in reduction mammaplasty","volume":"106","author":"Zubowski","year":"2000","journal-title":"Plast Reconstr Surg"},{"issue":"3","key":"2022120220531984600_CIT0004","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1067\/maj.2001.116439","article-title":"Breast reduction with use of the free nipple graft technique","volume":"21","author":"Colen","year":"2001","journal-title":"Aesthet Surg J"},{"issue":"4","key":"2022120220531984600_CIT0005","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1097\/00006534-200104010-00008","article-title":"Maximizing breast projection after free-nipple-graft reduction mammaplasty","volume":"107","author":"Casas","year":"2001","journal-title":"Plast Reconstr Surg"},{"issue":"4","key":"2022120220531984600_CIT0006","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1097\/00006534-197759040-00004","article-title":"Reduction mammaplasty by the inferior pedicle technique. An alternative to free nipple and areola grafting for severe macromastia or extreme ptosis","volume":"59","author":"Courtiss","year":"1977","journal-title":"Plast Reconstr Surg"},{"issue":"3","key":"2022120220531984600_CIT0007","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1097\/00006534-200003000-00011","article-title":"Medial pedicle reduction mammaplasty for severe mammary hypertrophy","volume":"105","author":"Nahabedian","year":"2000","journal-title":"Plast Reconstr Surg"},{"issue":"3","key":"2022120220531984600_CIT0008","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1097\/01.prs.0000299297.20908.66","article-title":"Choosing the superomedial pedicle for reduction mammaplasty in gigantomastia","volume":"121","author":"Landau","year":"2008","journal-title":"Plast Reconstr Surg"},{"issue":"4","key":"2022120220531984600_CIT0009","doi-asserted-by":"crossref","first-page":"252e","DOI":"10.1097\/PRS.0b013e3182268bb1","article-title":"Ultrasonographically determined pedicled breast reduction in severe gigantomastia","volume":"128","author":"Ba\u015faran","year":"2011","journal-title":"Plast Reconstr Surg"},{"issue":"1","key":"2022120220531984600_CIT0010","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1097\/PRS.0b013e3181c49561","article-title":"Breast reduction in gigantomastia using the posterosuperior pedicle: an alternative technique, based on preservation of the anterior intercostal artery perforators","volume":"125","author":"Mojallal","year":"2010","journal-title":"Plast Reconstr Surg"},{"issue":"1","key":"2022120220531984600_CIT0011","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s00266-007-9005-x","article-title":"Gigantomasty: treatment with a short vertical scar","volume":"32","author":"Heine","year":"2008","journal-title":"Aesthetic Plast Surg"},{"issue":"3","key":"2022120220531984600_CIT0012","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1097\/SAP.0b013e3181b0a5d8","article-title":"Vertical reduction mammaplasty combined with a superomedial pedicle in gigantomastia","volume":"64","author":"Amini","year":"2010","journal-title":"Ann Plast Surg"},{"issue":"1","key":"2022120220531984600_CIT0013","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/PRS.0000000000000802","article-title":"The short-scar periareolar inferior pedicle reduction technique in severe mammary hypertrophy","volume":"135","author":"Hammond","year":"2015","journal-title":"Plast Reconstr Surg"},{"issue":"2","key":"2022120220531984600_CIT0014","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1097\/00000637-199102000-00002","article-title":"Reduction mammoplasty with free-nipple transplantation: indications and technical refinements","volume":"26","author":"Oneal","year":"1991","journal-title":"Ann Plast Surg"},{"issue":"3","key":"2022120220531984600_CIT0015","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.bjps.2005.03.003","article-title":"Is there still a place for free nipple areolar grafting in breast reduction surgery? 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