Vertical reduction
mammaplasty using a superomedial pedicle is a well-accepted technique giving good results in mild to moderate breast
hypertrophy. We describe modifications of the vertical reduction technique to achieve safe reductions even for very large breasts and minimize unsightly
scarring, skin
necrosis and poor shape. Over the past 4 years, 162 patients have undergone bilateral breast reduction using the vertical
mammaplasty technique with a superomedial dermoglandular pedicle. We present a retrospective study of 23 cases of gigantomastia (reductions over 1100g) who underwent bilateral reduction
mammaplasty, using our technique. The mean age was 49 years, BMIs ranged from 28 to 52 kg/m. The mean suprasternal notch-to-nipple distance was 40.5 cm on the right and 41.4 cm on the left. The average resection weight per breast was 1303 g on the right, and 1245 g on the left side. The suprasternal notch-to-nipple distance was reduced by between 13.2 and 36.0 cm (mean, 16.1 cm). Mean follow-up was 14 months. We observed a superficial
infection in 2 patients, a deep
hematoma in one patient, partial
necrosis of the nipple-areola complex in 1, and 2 patients needed correction surgery due to dog-ear formation. By using the described modifications, the nipple and areola were safely transposed on a superomedial dermoglandular pedicle producing good breast shapes, while
scarring and complications in vertical reduction
mammaplasty for oversized breasts were effectively minimized.