Surgical Outcomes of Gigantomastia Breast Reduction with a Vertical Scar Superomedial Pedicle Technique: A 12 Year Retrospective Study

Friday, April 12, 2013
Liana M. Lugo, MD1, Margarita Prada, MD1, John Mesa, MD2, Som Kohanzadeh, MD1, James N. Long, MD3 and Jorge De la Torre4, (1)Plastic Surgery, UAB School of Medicine, Birmingham, AL, (2)Plastic Surgery, University of Alabama at Birmingham. Plastic Surgery Center Internationale, Montclair, NJ, (3)Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL, (4)Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL
Goals/Purpose:

Reduction mammoplasty in patients with gigantomastia is a challenge for plastic surgeons. Although several techniques have been described to reduce breast on these patients, often the nipple areola complex (NAC) is compromised (necrosis, decreased sensation, inability to breast feed, etc.). Vertical scar superomedial pedicle reduction mammoplasty technique (VS-SMP) has been demonstrated to be a safe and effective technique to reduce breasts with mild to moderate hypertrophy. The aim of this study is to determine the surgical outcomes of VS-SMP on patients with gigantomastia (resection weight >1000gm/breast) at our institution.

Methods/Technique: A retrospective study of all the patients that underwent reduction mammoplasty with vertical scar and superomedial pedicle technique by eight surgeons at a single institution between 1999 and 2011 was performed. Patient’s demographics, pre-operative breast measurements, and perioperative data was analyzed. Exclusion criteria consisted in reduction mammoplasty specimen weight less than 1000gm. 

Results/Complications:

Our results show that 200 of 1750 patients that underwent VS-SMP during the study period qualified for the study. The average age at the time of the reduction was 39 years old. The average BMI was 36. The average suprasternal notch to NAC distance was 35.5 cm for the right breast and 35.6 cm for the left breast. The average resection weight per breast was 1277g for the right and 1283g for the left. The average NAC transposition was 11.25 cm for the right breast and 11.40 cm for the left breast. Twenty one patients (10.5%) presented partial necrosis of NAC and 98% of the patients presented normal NAC sensation post-operatively. All patients exhibit an excellent breast shape and projection post-operatively.

Conclusion:

Our study shows that VS-SMP reduction mammoplasty in patients with gigantomastia is a safe and effective reduction mammoplasty technique associated with minimal NAC necrosis risk and excellent breast shape.