title: Ultrasonographically determined pedicled breast reduction in severe gigantomastia.
abstract: 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.
authors.affiliation: Istanbul, Turkey From the Departments of Plastic and Reconstructive Surgery and Radiology, Istanbul Medical Faculty.
authors.forename: Karaca
authors.initials: K
authors.lastname: Başaran
authors.forename: Adem
authors.initials: A
authors.lastname: Ucar
authors.forename: Erdem
authors.initials: E
authors.lastname: Guven
authors.forename: Atilla
authors.initials: A
authors.lastname: Arinci
authors.forename: Memet
authors.initials: M
authors.lastname: Yazar
authors.forename: Samet Vasfi
authors.initials: SV
authors.lastname: Kuvat
mesh_terms: D000328:Adult; D001940:Breast / Q000002:abnormalities / Q000601:surgery; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy / Q000000981:diagnostic imaging* / Q000601:surgery*; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D009558:Nipples / Q000098:blood supply / Q000601:surgery*; D018570:Risk Assessment; D013524:Surgical Flaps / Q000098:blood supply; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods; D055815:Young Adult