Postoperative complications in patients with breast hypertrophy following reduction mammoplasty depending on vascular pedicle

Objective. To compare the incidence of postoperative complications associated with reduction mammoplasty depending on pedicle (lateral, medial, upper, and lower). Material and methods. A prospective study involved 100 patients with breast hypertrophy (mean age 46.4 years, mean BMI 26.4 kg/m²) who underwent reduction mammoplasty between 2023 and 2026. Lateral pedicle was used in 40% of patients, medial pedicle in 30%, upper and lower pedicles in 15% each. The follow-up period was 12 months and included clinical examinations, palpation and breast ultrasound. Complications included hematomas, necrosis of NAC, delayed wound healing, loss of NAC sensitivity, liponecrosis / cysts and infectious complications. Results. The most common complication across all groups was loss of NAC sensitivity. Lateral pedicle significantly reduced the risks of various complications compared to other pedicles. There was lower risk of lost NAC sensitivity compared to all other pedicle types (p<0.05), lower risk of partial NAC necrosis and delayed wound healing compared to medial pedicle (p<0.05), lower risk of liponecrosis/cysts compared to medial and upper pedicles (p<0.05), and lower risk of infectious complications compared to upper and lower pedicles (p<0.05). However, no significant differences were found in the incidence of hematomas and total NAC necrosis (p>0.05). These findings align with global data on high incidence of complications associated with lower pedicle. However, there are few researches comparing lateral pedicle with others. Our results demonstrate the advantages of lateral pedicle in preserving sensitivity and preventing ischemic and infectious complications. Conclusion. Lateral pedicle in reduction mammoplasty is associated with significantly lower rate of postoperative complications compared to medial, upper and lower pedicles. Nevertheless, choice of technique should be individual.