Preoperative estimation of breast resection weight in patients undergoing inferior pedicle reduction mammoplasty: the Bilgen formula

Abstract

Background/aim: Symptomatic breast hypertrophy has a significant impact on the quality of life of women. The amount of tissueto be excised may be preoperatively estimated by an experienced surgeon. However, this remains a subjective assessment. Accuratequantification of the amount of breast tissue to be resected in the preoperative period will be a guide for both patient information andthe surgeon during the operation. The aim of this study is to develop a new method based on simple measurements that can accuratelyestimate the resection weight in the preoperative period in a wide range of patients undergoing reduction mammoplasty.Materials and methods: The study was carried out between December 2016 and September 2018. With the determined drawing andmeasurement methods, a triangle was obtained by measuring the distances among the sternal notch (A) - right nipple areola midpoint(B), sternal notch (A) - left nipple areola midpoint (C) and both internipple areola (B-C). The height of this triangle (h) was foundby measuring the distance between the sternal notch and the midpoint of both nipple areola levels. The amount of breast tissue to beresected for each breast was calculated by multiplying the distance between the sternal notch–nipple areola and the height of the largetriangle. The formula may be expressed as AB × h for the right breast and AC × h for left breast.Results: When the t values and significance levels of the beta coefficients of the independent variables were examined, the preoperativevalues were determined to be in accordance with the actual values after surgery (P < 0.05). The values calculated before were calculatedas the percentage of the actual values (91%). In other words, the R2 value showed that the calculated values were compatible with theactual values (R2 = 0.910).Conclusions: With the formula described herein, one may accurately estimate the amount of tissue to be resected in a wide rangeof patients undergoing reduction mammoplasty whose sternal notch–nipple distances are between 28–42 cm. Additionally, becausemeasurements for each breast are performed separately, breast asymmetry does not affect the results. In conclusion, the formula wedevised is simple, applicable, and has a high accuracy rate.