Abstract
IntroductionReduction mammaplasty in patients with gigantomastia is challenging. The Double-Unit technique with a Superomedio-Central pedicle and inverted-T incision is the standard technique for reduction mammaplasty in our clinic. The aim of this study was to review our approach in cases with gigantomastia in comparison with the current literature.Patients and MethodsFrom 01/2011 to 12/2017, we performed 831 reduction mammaplasties in 630 patients. The Double-Unit Superomedio-Central (DUS) pedicle and inverted-T incision was implemented as a standard procedure for gigantomastia. Patient demographics and the outcome parameters complication rate, patient satisfaction with the aesthetic result, nipple sensibility, and surgical revision rate were obtained and retrospectively analyzed.ResultsIn 37 patients, 55 reduction mammaplasties were performed with more than 1000 g per breast. Mean resection weight was 1311 g on right side and 1289 g on left side. Mean age was 52.5 years, mean body mass index was 32.8 kg/m2, mean sternal-notch-to-nipple distance was 38.3 cm. A free NAC graft was necessary in four breasts. Overall complication rate was 14.5%; secondary surgical revision rate was 12.7%. 91% of the patients were “very satisfied” and “satisfied” with the aesthetic result. Nipple sensibility was rated “high” and “medium” in 83%.ConclusionThe Double-Unit technique with a Superomedio-Central pedicle and inverted-T incision is very effective to achieve volume reduction and aesthetically pleasing reproducible results with a low complication rate in cases with gigantomastia.Level of EvidenceLevel of Evidence This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Highlights
Reduction mammaplasty in patients with gigantomastia is challenging
The Double-Unit technique with a Superomedio-Central pedicle and inverted-T incision is the standard technique for reduction mammaplasty in our clinic
The aim of this study was to review our approach in cases with gigantomastia in comparison with the current literature
Summary
‘‘Gigantomastia’’ describes a rare extreme hypertrophy of the female breast. there is no universally accepted definition, many authors cite gigantomastia as breast enlargement that requires a reduction mammaplasty of [1000 g per breast [1,2,3,4]. The purpose of this study is to show a modification of Hall-Findlay’s technique with a Double-Unit Superomedio-Central pedicled inverted-T-scar reduction mammaplasty in gigantomastia and a retrospective analysis regarding complications, patient satisfaction, and NAC sensibility. The data collected included patient demographics (age, body mass index (BMI kg/m2), SNNAC distance, operation time, hospital stay, and amount of resected breast tissue (Table 1). Outcome parameters such as complication rate, patient satisfaction with the aesthetic result, nipple sensibility, and the secondary revision rate were recorded and evaluated (Tables 2 and 3). It divides the breast into cranial and caudal parts The surgical team usually consists of one or two attendings and one resident
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