Gigantomasty: treatment with a short vertical scar

During the past 15 years, reduction mammoplasty with a short vertical scar has become increasingly common in the world of plastic surgery. Still, the indication for this technique often is limited to smaller reduction weights, so that the inverted T-scar techniques have yet to be regarded as the gold standard for excessive breast hypertrophy.

In the authors' department, their own modification of vertical scar reduction mammoplasty, based on the techniques of C. Lassus, G. Maillard, and M. Lejour, has been performed since 1990. During the past 10 years, the authors have used it for all breast sizes. To investigate the safety and the results for patients with very large breast volumes (gigantomasty involving at least > or =1,000 g of excised tissue per one side), this study retrospectively evaluated 25 women with a mean age of 43.1 +/- 11.2 years who underwent surgery from January 2002 to June 2003. A protocol was used to record patient satisfaction and complaints and to quantify the final result objectively.

The average resection weight for the 25 women was 1,227 +/- 300 g (maximum, 2,300 g) on the right side and 1,218 +/- 343 g (maximum, 2,100 g) on the left side. The sternal notch-to-nipple distance was reduced from 37.1 +/- 4 cm to 23.4 +/- 2.1 cm on the right side and from 37.4 +/- 3.5 cm to 24 +/- 2 cm on the left side. The brassiere size was reduced by about three cup sizes on the average. During an average follow-up period of 2 years (n = 15), patient satisfaction was high, with good acceptance of the breast shape and a low rate of major complications (12%).

The results suggest that the authors' modified vertical scar technique can be used successfully for all dimensions of reduction mammoplasty regardless of breast weight.