The vertical reduction mammaplasty with a superior nipple-areola complex-bearing pedicle is a frequently used technique for the treatment of macromastia. However, complications occur using this technique as well as in other techniques. Complications depending on the arterial and venous perfusion of the nipple-areola complex and wound healing problems can be found beside other complications. But the preoperative evaluation of possible complications turned out to be difficult. Former studies dealing with the relationship between preoperative data and postoperative complications have shown that there is no simple clinical parameter to evaluate the risk of postoperative complications. In this study we analyzed postoperative complications of 104 patients undergoing vertical reduction mammaplasty (Lejour’s technique or modified L-Technique) with a superior lipodermal pedicle at the department of Plastic Surgery, Reconstructive and Hand Surgery of the University Hospital Aachen. Apart from the jugulo-mamillar measure as the main determining factor other parameters like age, weight, height, body mass index, chest measurement and breast size were acquired. The occurring complications were documented separately for each breast. (n=208) Using logistic regressions we analyzed the correlation between the length of the jugulo-mamillar measure and arterial and venous circulatory disorders. The level of significance was set as p=0,025. Other data was analyzed descriptively. Among our patients we noted that venous circulatory disorders appeared significantly more often in cases with a jugulo-mamillar measure of 30 centimetres or more (p=0,0017). Arterial circulatory disorders did not appear significantly more frequently in these cases (p=0,2319). Furthermore we observed wound healing disorders concerning the region of the nipple-areola complex and the vertical scar in patients with a jugulo-mamillar measure of 30 centimetres or more. Patients with venous circulatory disorder showed wound healing disorders of the nipple-areola complex in 47,4%. 9 patients needed surgical revision of the nipple-areola complex (8,7%). These results allow the conclusion that the jugulo-mamillar measure is a simple but important clinical parameter evaluating the risk of postoperative complications caused by circulatory disorder of the nipple-areola complex and the vertical scar. Patients with a jugulo-mamillar measure of 30 centimetres or more should be treated with specific attention during the perioperative course
