Parenchyma manipulation, undermining and resection is always restricted to the lower pole. Superposing the flaps accomplishes a decrease in width of breast base. Dressing is an important aspect of this technique. Explanation should be given as to the temporary presence of pleats which usually disappear over the first three months, while the skin adapts to the new volume of breast. The rate of complications for all three techniques is very small.
All dead space is closed with the approximation of remaining tissue.
There is little risk of flap or nipple ischemia, because breast parenchyma is not separated from overlying skin. She was submitted to a classic Pitanguy breast reduction, with removal of 650g from the right and 500g from the left. Two years post-operative views, showing good symmetry and maintenance of pleasant shape. A classic technique was performed, with removal of approximately 700g from each breast. Four years following surgery the patient refers relief of physical symptoms.