Double-Unit Superomedio-Central (DUS) Pedicle Inverted-T Reduction Mammaplasty in Gigantomastia: A 7-year Single-Center Retrospective Study

Aesthetic Plast Surg. 2021 Oct;45(5):2061-2074. doi: 10.1007/s00266-021-02351-y. Epub 2021 Jun 18.

Abstract

Introduction: Reduction mammaplasty in patients with gigantomastia is challenging. The Double-Unit technique with a Superomedio-Central pedicle and inverted-T incision is the standard technique for reduction mammaplasty in our clinic. The aim of this study was to review our approach in cases with gigantomastia in comparison with the current literature.

Patients and methods: From 01/2011 to 12/2017, we performed 831 reduction mammaplasties in 630 patients. The Double-Unit Superomedio-Central (DUS) pedicle and inverted-T incision was implemented as a standard procedure for gigantomastia. Patient demographics and the outcome parameters complication rate, patient satisfaction with the aesthetic result, nipple sensibility, and surgical revision rate were obtained and retrospectively analyzed.

Results: In 37 patients, 55 reduction mammaplasties were performed with more than 1000 g per breast. Mean resection weight was 1311 g on right side and 1289 g on left side. Mean age was 52.5 years, mean body mass index was 32.8 kg/m2, mean sternal-notch-to-nipple distance was 38.3 cm. A free NAC graft was necessary in four breasts. Overall complication rate was 14.5%; secondary surgical revision rate was 12.7%. 91% of the patients were "very satisfied" and "satisfied" with the aesthetic result. Nipple sensibility was rated "high" and "medium" in 83%.

Conclusion: The Double-Unit technique with a Superomedio-Central pedicle and inverted-T incision is very effective to achieve volume reduction and aesthetically pleasing reproducible results with a low complication rate in cases with gigantomastia.

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Keywords: Breast reduction; Gigantomastia; Macromastia; Reduction mammaplasty; Severe mammahypertrophy; Superomedial pedicle.

MeSH terms

  • Breast / abnormalities
  • Breast / surgery
  • Esthetics
  • Female
  • Humans
  • Hypertrophy / surgery
  • Mammaplasty*
  • Middle Aged
  • Nipples / surgery
  • Retrospective Studies
  • Risk Assessment
  • Surgical Flaps*
  • Treatment Outcome

Supplementary concepts

  • Gigantomastia