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Ultrasonographically determined pedicled breast reduction in severe gigantomastia
Karaca Başaran1, Adem Ucar, Erdem Guven
1Istanbul, Turkey From the Departments of Plastic and Reconstructive Surgery and Radiology, Istanbul Medical Faculty.
Background:
The free nipple breast reduction method has certain disadvantages, such as nipple hyposensitivity, loss of lactation, and loss of projection. To eliminate these risks, the authors describe a patient-based breast reduction technique in which the major supplier vessels of the nipple-areola complex were determined by color Doppler ultrasonography. Pedicles containing these vessels were designed for reductions.
Methods:
Sixteen severe gigantomastia patients with a mean age of 41 years (range, 23 to 60 years) were included in the study. Major nipple-areola complex perforators were determined with 13- to 5-MHz linear probe Doppler ultrasonography before surgery. Pedicles were designed according to the vessel locations, and reductions were performed with superomedial-, superolateral-, or mediolateral-based designs.
Results:
Different combinations of internal mammary and lateral thoracic artery perforator-based reductions were achieved. None of the patients had areola necrosis. Mean reduction weight was 1795 g (range, 1320 to 2280) per breast.
Conclusions:
Instead of using standard markings for severe gigantomastia patients, custom-made and sonographically determined pedicles were used. This technique can be considered as a "guide" for the surgeon during very large breast reductions.
