Clavicle height asymmetry: A common problem for planning reduction mammoplasties - A correlational study

M-A Pais; A Kucinskaite; S Graul; R Loucas; R Giunta; S Leitsch; T Holzbach

doi:10.1016/j.bjps.2024.12.003

Clavicle height asymmetry: A common problem for planning reduction mammoplasties - A correlational study

J Plast Reconstr Aesthet Surg. 2024 Dec 17:101:164-173. doi: 10.1016/j.bjps.2024.12.003. Online ahead of print.

Authors

M-A Pais¹, A Kucinskaite², S Graul³, R Loucas⁴, R Giunta⁵, S Leitsch³, T Holzbach⁶

Affiliations

¹ Department of Hand and Plastic Surgery, Thurgau Hospital Group, Frauenfeld, Switzerland; Department of Plastic and Reconstructive Surgery, BG Trauma Center Ludwigshafen, University of Heidelberg, Germany; Department for BioMedical Research, University of Bern, Bern, Switzerland. Electronic address: michaelalexander.pais@gmail.com.
² Department of Hand and Plastic Surgery, Thurgau Hospital Group, Frauenfeld, Switzerland; Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
³ Department of Hand and Plastic Surgery, Thurgau Hospital Group, Frauenfeld, Switzerland.
⁴ Department of Hand and Plastic Surgery, Thurgau Hospital Group, Frauenfeld, Switzerland; Centre of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, Regensburg, Germany.
⁵ Division of Hand, Plastic and Aesthetic Surgery University Hospital, LMU Munich, Germany.
⁶ Department of Hand and Plastic Surgery, Thurgau Hospital Group, Frauenfeld, Switzerland; Division of Hand, Plastic and Aesthetic Surgery University Hospital, LMU Munich, Germany.

PMID: 39787769
DOI: 10.1016/j.bjps.2024.12.003

Abstract

The distance between the mid-clavicle and nipple (MCN) is crucial in planning reduction mammoplasties. MCN has been shown to be superior in achieving nipple-areola complex symmetry. However, there is great variability in clavicle anatomy. Detecting clavicle asymmetries is crucial for achieving optimal postoperative breast symmetry. This study assessed clavicle asymmetries in patients undergoing reduction mammoplasties and used correlation analyses to understand the outcome measures, including variations in resection weight and clavicle angles. We included 100 patients who underwent reduction mammoplasties with wise-pattern skin resections. Clavicle height asymmetries were identified through preoperative anthropometric measurements. Clavicle angles were assessed from pre- and postoperative images to differentiate between fixed and dynamic asymmetries. Statistical analyses used frequency distributions, generalized linear models, and logistic regression. Clavicle height differences were identified in 78% of the patients using preoperative anthropometric measurements. Pre- and postoperative images revealed fixed clavicle angle differences in 45% of the cases and dynamic differences in 16%. Dynamic clavicle height asymmetries were significantly associated with differences in resection weight between the breasts (p = 0.012), smaller differences in clavicle angles (p = 0.006), and patients aged 40 to 64 years (p = 0.038). Fixed asymmetries correlated with larger differences in clavicle angles (p = 0.023). Clavicle height asymmetry is common in reduction mammoplasty patients. Differentiating dynamics from fixed asymmetries preoperatively is important, as this study demonstrates significant correlations with resection weight, clavicle angles, and age. These findings suggest that compensatory clavicular asymmetries play a significant role in cases of pre-existing breast asymmetry, affecting surgical planning.

Keywords: Anthropometric measurements; Breast reduction; Breast symmetry; Clavicle asymmetry; Reduction mammoplasty.