How to Avoid Pseudoptosis after Lifting and Breast Reduction Mammaplasties

Pseudoptosis or “bottoming-out” is a common complication following breast reduction. It is secondary to five causal phenomena: improper determination of nipple placement, dissociation of the nipple from the gland, dissociation between different parcels of a reconstituted breast, improper evaluation of the skin to be resected and weakness of the inferior dermal arch. The total posterior pedicle breast reduction technique was described by Richard Moufarrege in 1982. It consists of dissecting the skin away from the breast tissue offering free access to all breast quadrants. This technique is known for its robust blood supply to the nipple areolar complex, the preservation of the nipple areolar complex sensation, and for the conservation of the breastfeeding function. In this article, we also elucidate the reasons why the Moufarrege Total Posterior Pedicle breast reduction technique has a lowest rate of postoperative pseudoptosis.