The Free-Nipple Breast-Reduction Technique Performed with Transfer of the Nipple–Areola Complex Over the Superior or Superomedial Pedicles
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Although the free-nipple breast-reduction technique is essentially an amputation, achieving aesthetic results still is important. The authors present their technique for free nipple–areola complex (NAC) transfer over the superomedial or superior pedicle full-thickness flaps in patients for whom a free-nipple technique is inevitable due to certain risk factors.
The study included 25 patients who underwent surgery with the aforementioned method for addressing severe gigantomastia. The patients had a mean age of 43 years (range 34–59 years) and a mean body mass index (BMI) of 35.8 kg/m2 (range 28–42 kg/m2). During the operation, the NAC was elevated as a full-thickness skin graft, then transposed to the superior or superomedial pedicles, which had been planned previously. The subsequent stages of the operation thus became a Wise-pattern breast reduction.
The mean resection per breast was 1,815 g (range 1,620–2,410 g). Breast projection, shape, and areolar pigmentation were assessed during the follow-up visit. One patient experienced a partial loss of the NAC graft, which healed secondarily, and three patients experienced a patchy hypopigmentation of the NAC. Breast projection and conical structure were observed to be preserved during the follow-up period.
The modified free-nipple technique aimed to convert the reduction procedure to a technique similar to pedicle methods, yielding successful results during the early phases. The full-thickness flap constructed in this way provides more fullness and a maximum contribution to projection in patients who will inevitably undergo breast reduction with the free-nipple method.
Level of Evidence IV
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KeywordsFree-nipple breast reduction Projection Superior pedicle Superomedial pedicle
None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.
Free-nipple breast-reduction technique performed with transfer of the nipple–areola complex over the superior pedicle. (MP4 12132 kb)
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