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Central Pedicle Reduction in Gigantomastia Without Free Nipple Graft

Karacor-Altuntas, Zeynep MD; Dadaci, Mehmet MD; Ince, Bilsev MD; Karamese, Mehtap MD; Savaci, Nedim MD

doi: 10.1097/SAP.0000000000000388
Breast Surgery
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Background Various pedicle techniques have been described in breast reduction surgery. However, in cases of massive hypertrophy, the free nipple graft technique is still being performed by some surgeons out of fear of losing the nipple-areolar complex (NAC). As such, we evaluated patients with severe gigantomastia who underwent the central pedicle horizontal scar reduction mammaplasty technique.

Methods The records of 257 patients who underwent the central pedicle reduction technique were retrospectively reviewed. The demographic properties of the patients and the distances from the midclavicular point to the nipple were recorded. Patients whose distance from the midclavicular point to both nipple areolar complexes (NACs) was 38 cm or greater were included in this study. Resection weights and postoperative complications were evaluated.

Results The distance from the midclavicular point to both NACs was 38 cm or greater in 53 patients (106 breasts). The age range of the patients was 17 to 73 years, and the mean body mass index was 39.6 kg/m2. The range of distances from the midclavicular point to the nipple was 38 to 52 cm. The weight of the breast tissue excised ranged between 1450 and 2785 g. None of the patients experienced total nipple loss postoperatively, and all of the patients were satisfied with the aesthetic results.

Conclusion We were able to reduce all of the breasts safely, without using the free nipple grafting technique, even in very large breasts. This study shows that the central pedicle horizontal scar reduction technique is a very safe and effective method for use in massive reductions. Therefore, we strongly recommend using the central pedicle reduction mammaplasty technique in cases of gigantomastia.

From the *Department of Plastic, Reconstructive and Aesthetic Surgery, School of Medicine, Necmettin Erbakan University, Konya, Turkey; and †Department of Plastic, Reconstructive and Aesthetic Surgery, School of Medicine, Selcuk University, Konya, Turkey.

Received June 30, 2014, and accepted for publication, after revision, October 16, 2014.

Conflicts of interest and sources of funding: The research was not sponsored by an outside organization. We (all of the authors) have agreed to allow full access to the primary data and to allow the journal to review the data if requested. None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.

Reprints: Zeynep Karacor-Altuntas, MD, Department of Plastic, Reconstructive and Aesthetic Surgery, School of Medicine, Necmettin Erbakan University, 42080 Meram, Konya, Turkey. E-mail: zeynepkaracor@yahoo.com.

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