Combined Superior and Inferior Dermoglandular Flaps for Projection Enhancement in Gigantic Breast Amputation and Free Nipple Areola Graft

Abstract

Background: Breast amputation and free nipple areola complex (NAC) graft is reserved mainly for cases of gigantomastia. This technique usually ends by flat boxy breast without projection. Many flaps have been used to overcome the flat boxy breast. The superior and inferior flaps were used in 20 cases of gigantomastia during the period between March 2014 and October 2018. The technique, results, and complications will be presented and discussed.The Aim of the Work: The aim of this study is to emphasize the efficacy of using combined superior and inferior flaps for projection enhancement in breast amputation and free NAC graft surgery. Patients and Methods:A prospective study was conducted on 20 cases of gigantomastia at Al-Azhar University Hospitals. The classic breast amputation was done in conjunction with elevation of superior and inferior flaps. The average dimensions of the flaps were 8x13cm. The free ends of both flaps were sutured together and fixed to the pectoral fascia by sutures at the upper part of the breast. The procedure was completed as a wise pattern technique and ended by an inverted T scar. All patients were followed-up for a period of 6 months. Results:Regarding projection enhancement which is the main target of this study, all cases showed increases projection that ranged from excellent in 14 cases (70%) to good in 6 cases (30%) according tothe designed questionnaire. Conclusion:Adding superior and inferior dermoglandular flaps in breast amputation and free NAC graft enhances breast projection, decreases the boxy appearance and bottoming out rate of breast.

Combined superior and inferior dermoglandular flaps for projection enhancement in giantic breast amputation and free nipple areola graft

“…We encountered a similar issue in our research, most likely as a result of doing Wise pattern skin resection on studied cases with moderate to severe breast enlargement, that increased scar tension & necessitated the removal of more parenchymal & adipose tissue. (17) Both functional & aesthetic concerns should be addressed during breast reduction surgery. Because it may be used to treat a variety of breast hypertrophies, reduce breast weight in a reproducible manner, & produce outcomes that have been aesthetically pleasing for both studied cases & surgeons, we discovered medial-pedicle-based reduction mammoplasty to be effective & dependable.…”

“…(10) Figure 2. Combined Superior & Inferior Dermoglandular Flaps for Projection Enhancement in Gigantic Breast Amputation & Free Nipple Areola Graft (19)…”