Medial pedicle deepithelialized
Fig. 7.3. The design of the vertical skin pattern with the medially based pedicle.The orientation of the base of the pedicle can be altered, but I have found that the pedicle is consistently easy to inset when half of the base is in the areolar opening and half is in the vertical opening. If the base is completely in the areolar opening, it can have the same problems as the superior pedicle with difficulty insetting. If the base is completely in the vertical opening, it can cause difficulties in rotation, and it may mean that there is too much inferior fullness, which can lead to pseudoptosis
The base of the pedicle should measure about 6 to 10 cm. The determining factor would be the length of the pedicle, but, as with the inferior pedicle, the base width probably does not need to be increased significantly to ensure good blood supply. I normally use a base width of 6 cm for the smaller (400 g) reductions, 8 cm for the medium-sized (800 g) reductions, and about 10 cm for the larger reductions. I wish I could provide a rationale for this,but my design is not based on any scientific data.
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