Aesthetic Plastic Surgery

, Volume 38, Issue 4, pp 718–726 | Cite as

The Free-Nipple Breast-Reduction Technique Performed with Transfer of the Nipple–Areola Complex Over the Superior or Superomedial Pedicles

  • Karaca BasaranEmail author
  • Funda Akoz Saydam
  • Idris Ersin
  • Memet Yazar
  • Ahmet Cemal Aygit
Multimedia Manuscript Breast



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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Free-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.

Supplementary material

Video 1

Free-nipple breast-reduction technique performed with transfer of the nipple–areola complex over the superior pedicle. (MP4 12132 kb)


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Copyright information

© Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2014

Authors and Affiliations

  • Karaca Basaran
    • 1
    Email author
  • Funda Akoz Saydam
    • 1
  • Idris Ersin
    • 1
  • Memet Yazar
    • 2
  • Ahmet Cemal Aygit
    • 3
  1. 1.Department of Plastic and Reconstructive SurgeryBagcilar Research and Training HospitalIstanbulTurkey
  2. 2.Department of Plastic, Reconstructive and Aesthetic SurgerySisli Etfal Hospital IstanbulIstanbulTurkey
  3. 3.Department of Plastic, Reconstructive, and Aesthetic SurgeryIstanbul Kemerburgaz UniversityIstanbulTurkey

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