Combined Superior and Inferior Dermoglandular Flaps for Projection Enhancement in Gigantic Breast Amputation and Free Nipple Areola Graft

Abstract

Background: Breast amputation and free nipple areolacomplex (NAC) graft is reserved mainly for cases of gigantomastia.This technique usually ends by flat boxy breastwithout projection. Many flaps have been used to overcomethe flat boxy breast. The superior and inferior flaps were usedin 20 cases of gigantomastia during the period between March2014 and October 2018. The technique, results, and complicationswill be presented and discussed.The Aim of the Work: The aim of this study is to emphasizethe efficacy of using combined superior and inferior flaps forprojection enhancement in breast amputation and free NACgraft surgery.Patients and Methods: A prospective study was conductedon 20 cases of gigantomastia at Al-Azhar University Hospitals.The classic breast amputation was done in conjunction withelevation of superior and inferior flaps. The average dimensionsof the flaps were 8x13cm. The free ends of both flaps weresutured together and fixed to the pectoral fascia by sutures atthe upper part of the breast. The procedure was completed asa wise pattern technique and ended by an inverted T scar. Allpatients were followed-up for a period of 6 months.Results: Regarding projection enhancement which is themain target of this study, all cases showed increases projectionthat ranged from excellent in 14 cases (70%) to good in 6cases (30%) according tothe designed questionnaire.Conclusion: Adding superior and inferior dermoglandularflaps in breast amputation and free NAC graft enhances breastprojection, decreases the boxy appearance and bottoming outrate of breast.