title: Central Pedicle Reduction in Gigantomastia Without Free Nipple Graft.
abstract: BACKGROUND
  Various pedicle techniques have been described in breast reduction surgery. However, in cases of massive hypertrophy, the free nipple graft technique is still being performed by some surgeons out of fear of losing the nipple-areolar complex (NAC). As such, we evaluated patients with severe gigantomastia who underwent the central pedicle horizontal scar reduction mammaplasty technique.
  
  
  METHODS
  The records of 257 patients who underwent the central pedicle reduction technique were retrospectively reviewed. The demographic properties of the patients and the distances from the midclavicular point to the nipple were recorded. Patients whose distance from the midclavicular point to both nipple areolar complexes (NACs) was 38 cm or greater were included in this study. Resection weights and postoperative complications were evaluated.
  
  
  RESULTS
  The distance from the midclavicular point to both NACs was 38 cm or greater in 53 patients (106 breasts). The age range of the patients was 17 to 73 years, and the mean body mass index was 39.6 kg/m. The range of distances from the midclavicular point to the nipple was 38 to 52 cm. The weight of the breast tissue excised ranged between 1450 and 2785 g. None of the patients experienced total nipple loss postoperatively, and all of the patients were satisfied with the aesthetic results.
  
  
  CONCLUSIONS
  We were able to reduce all of the breasts safely, without using the free nipple grafting technique, even in very large breasts. This study shows that the central pedicle horizontal scar reduction technique is a very safe and effective method for use in massive reductions. Therefore, we strongly recommend using the central pedicle reduction mammaplasty technique in cases of gigantomastia.
authors.affiliation: From the *Department of Plastic, Reconstructive and Aesthetic Surgery, School of Medicine, Necmettin Erbakan University, Konya, Turkey; and †Department of Plastic, Reconstructive and Aesthetic Surgery, School of Medicine, Selcuk University, Konya, Turkey.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Karacor-Altuntas
authors.forename: Mehmet
authors.initials: M
authors.lastname: Dadaci
authors.forename: Bilsev
authors.initials: B
authors.lastname: Ince
authors.forename: Mehtap
authors.initials: M
authors.lastname: Karamese
authors.forename: Nedim
authors.initials: N
authors.lastname: Savaci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001940:Breast / Q000002:abnormalities* / Q000601:surgery; D002921:Cicatrix / Q000209:etiology / Q000517:prevention & control; D004954:Esthetics; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000601:surgery*; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D009558:Nipples / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult