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SPAIR (Short-scar Periareolar-Inferior pedicle Reduction) is a short-scar breast surgery techniquedeveloped by Dennis C Hammond.[1][2] This surgery technique was designed to allow a better-shaped breast, a limited amount of scarring, and a more accelerated healing process, by eliminating the lateral scar beneath the breast found in conventional breast reduction surgery.[3] The technique is considered to be a good alternative to vertical mammoplasty.[4]

Short-scar refers to the smaller, shorter (when compared to conventional breast reduction methods), vertical-only scar. Periareolar refers to the cutting around the areola and running vertically down to the underside of the breast. Inferior Pedicle refers to leaving the nipple attached on the inside of the breast. It is of note that the inferior pedicle is the standard pedicle used in all breast reduction surgeries to preserve nipple function (breast feeding and sensitivity), not just SPAIR.[3]

SPAIR vs. traditional breast reduction[edit]

Conventional breast reduction procedures typically result in a long scar which runs laterally along the underside of the breast from the chest wall to the mid-portion of the sternum. Additional scarring can be found up the center of the breast and around the nipple and areola. This operation successfully reduces the size of the breast, but is often associated with pronounced or hypertrophic scarring.[3] Also, the shape created at the time of surgery is often lost due to a large portion of the glandular tissue settling down below the nipple areola complex and the inframammary fold, creating what is referred to as a "bottomed-out" appearance.[5]

The SPAIR technique was designed to utilize the rounded contours of the breast, reduce breast volume, and maintain the natural curves of the breast. In the SPAIR technique, tissue is removed from around the nipple and the areola in a semi-circular fashion. The upper pole of the breast remains untouched, leaving the breast itself to maintain the natural soft curves. running from the outer portion of the breast, over to the inner chest wall.[1] In order to reposition the nipple upward onto the new breast mound, some of its attachments must be severed. However, the nipple is left attached to a stalk of tissue from within the breast which is designed to include nerve endings and blood supply. Scarring is minimal as a result of a single incision that passes around the nipple and areola and straight down to the inframammary fold. The wide scar along the underside of the breast found by conventional procedures is eliminated.


  1. ^ a b Hammond DC (1999), Short-scar periareolar-inferior pedicle reduction (SPAIR) mammoplasty, doi:10.1097/00006534-199903000-00018, PMID 10077079 
  2. ^ David L. Brown, Gregory H. Borschel (2004), Michigan Manual of Plastic Surgery 
  3. ^ a b c Moustapha Hamdi, Dennis C. Hammond, Foad Nahai (2005), Vertical scar mammaplasty, p. 3 
  4. ^ Restifo, Richard J. (April 1999), "Early Experience with SPAIR Mammaplasty: A Useful Alternative to Vertical Mammoplasty", Annals of Plastic Surgery 42 
  5. ^ Moustapha Hamdi, Dennis C. Hammond, Foad Nahai (2005), Vertical scar mammaplasty, p. 2