Breast Reduction and Mastopexy

This chapter describes the surgical techniques and imaging protocols for breast reduction and mastopexy. Breast reduction surgery addresses hypertrophy by reducing glandular, fatty, and skin volume, often reshaping the breast, and employing various scar patterns like peri-areolar, vertical, or an "inverted T" scar. Mastopexy, or breast lift, similarly aims to elevate the breast by removing excess skin and may include implant placement for volume enhancement, particularly after significant weight loss or pregnancy. The imaging protocol for these procedures includes mammography with both front and oblique views, tomosynthesis, and ultrasound, especially for dense breasts. MRI is not recommended in the preoperative assessment or for follow-up. Preoperative assessments are typically done 6 months to a year before surgery. Follow-ups post-surgery mirror those of the general population, with no immediate postoperative imaging unless necessary. Imaging after mastopexy is crucial for establishing a new baseline for future comparisons. Common findings include fibrous retractile scars, changes in gland architecture, and possible complications like fat necrosis. This chapter underscores the importance of accurate imaging interpretation post-surgery to differentiate between normal postoperative changes and potential abnormalities, avoiding misdiagnosis and ensuring appropriate management.