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Afschin Ghofrani

Afschin Ghofrani

Aestheticon®, Plastic and Aesthetic Surgery Centre, United Arab Emirates

Title: Mammareduction with central pedicle

Biography

Afschin Ghofrani’s current position as the Medical Director and owner of Aestheticon® has been the path of an ever increasing level of specialization with a constant focus on Plastic Surgery and Hand Surgery since 1992 and further concentration on Aesthetic Surgery since 1997. He studied human medicine and graduated at Europe's largest clinic, the RWTH. In 1992 he started his medical career at the Clinic of Burns and Plastic-Reconstructive Surgery in Aachen. In 1998 he received the certificate ‘Specialist of Plastic Surgery’ from the medical chamber in Nordrhein-Westfalen/ Germany and in 2001 the additional certificate ‘Specialist of Hand Surgery’. From January 2003 until August 2010 Dr. Afschin has been the Head Physician at the Evangelische Hospital Giessen/ Germany and additionally the Medical Director of his private practice of Plastic/Aesthetic Surgery and Hand Surgery. Regarding Dr. Afschin’s scientific career, he was the initiator and leader of various research projects and has published diverse articles in national and international specialists’ journals and books. Consistently he is invited to give lectures at scientific conferences and workshops.

Abstract

Introduction: There is possibly no other surgical technique in plastic surgery that has been modified more often than the mammaplasty. Numerous publications have focussed on this issue. Regarding the visible scars there are mainly three approaches 1) Periareolar scar, 2) I-scar, and 3) T-scar. Another variable is the pedicle. Since 1996 we use a central pedicle combined with a T-scar with short sub mammary part for most of the cases. Methods: The “inferior pedicle technique” was modified by Dr. Serdar Erenin in 1990. This modified approach is described by a detaching of the inferior part of the pedicle leaving only the central pectoral fascia attached. The blood supply is guaranteed by the intercostal perforators. The main sensory branch to the areola is routinely preserved thus maintaining a sensitive nipple in most cases. Because no dissection from the Nipple-Areola-Complex (NAC) from the gland is necessary, breast feeding after surgery is usually preserved. This pedicle gives a maximum degree of freedom regarding resection and positioning of the gland. Especially the hypertrophic lateral gland parts can be resected extensively down to the pectoral fascia. Results/ Discussion: We overlook more than 1000 mammoplasties performed with this pedicle-technique in the recent 20 years. This technique is not recommended for an inexperienced surgeon due to potential pitfalls in the preparation of the gland. Provided sufficient familiarisation with the procedure, however, this technique can be regarded as a safe method for almost all type of breast with excellent results in terms of shape and projection. Generally, breast feeding property and sensation of the NAC are preserved.