Superiomedial Pedicle Breast Reduction for Gigantic Breast Hypertrophy: Experience in 341 Breasts and Suggested Safety Modifications

Singolda, Roei; Bracha, Gal; Tariq, Zoabi; Zaretski, Arik; Inbal, Amir; Gur, Eyal; Barnea, Yoav; Arad, Ehud

doi:10.1007/s00266-020-01973-y

Cited by 21 publications

(43 citation statements)

References 39 publications

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“…Year of publication ranged from 1980 to 2020. [9][10][11] Study population size ranged from 10 to 217 patients, 9,12,13 with a total cohort of 1689 patients. Because of a minority of patients undergoing unilateral breast reductions, the total number of breasts included was 3352.…”

Section: Resultsmentioning

confidence: 99%

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Nipple-Sparing Gigantomastia Breast Reduction

et al. 2023

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Introduction There remains an unclear definition of the term “gigantomastia,” with many studies using different parameters and measurements. Currently, the operative management and patient education for gigantomastia are outdated. The historical teaching that a free nipple graft is necessary in elongated pedicles to avoid nipple necrosis may not be factual. The principal goal of our review aims to determine the safety of nipple-sparing breast reductions on large ptotic breasts via complication rate analysis. Methods The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines of conduct for systematic review and meta-analysis. In October 2021, PubMed was used to search the US National Library of Medicine database. Rayyan Intelligent Systematic Review aided in screening studies by title then abstract. If inclusion criteria were met, the entire article was reviewed. Results Twenty-two articles satisfied the inclusion and exclusion criteria. The study was composed of 1689 total patients with a mean body mass index of 32.9 (±3.4). Mean midclavicle-to-nipple distance and resection weight per breast was 39 cm (±3.8) and 1423.8 g (±268.9), respectively. A Wise pattern was preferred in 77.3% of the studies, with an inferior (45.5%) and superomedial (45.5%) pedicle used most commonly. Complete nipple areolar complex necrosis (1.7%) was found in 4 studies, whereas partial (5.9%) was observed in 11. More common complications included delayed wound healing (17.4%), surgical site infection (14.3%), seroma (10.5%), scar hypertrophy (9.9%), and wound dehiscence (9.2%). Conclusion Nipple-sparing breast reduction surgery can be safely performed on hypertrophic and severely ptotic breasts with nipple areolar complications, such as partial or complete nipple areolar complex loss, at a rate less than previously believed.

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Section: Resultsmentioning

confidence: 99%

“…Year of publication ranged from 1980 to 2020 9–11 . Study population size ranged from 10 to 217 patients, 9,12,13 with a total cohort of 1689 patients.…”

Section: Resultsmentioning

confidence: 99%

Nipple-Sparing Gigantomastia Breast Reduction

et al. 2023

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“…Individualized approach and thorough preoperative planning are the hallmarks of a successful operation, with good functional and aesthetic results. 1,3…”

Section: Discussionmentioning

confidence: 99%

“…The goal of surgery is to decrease breast volume while creating a predictable and stable breast shape, improving symptomatology and appearance. 1…”

Section: Introductionmentioning

confidence: 99%

A Modified Dissection of the Superomedial Pedicle

Fotiou

Savva

Vassiliou

2022

Plastic and Reconstructive Surgery - Global Open

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Background: The superomedial pedicle is a widely used technique in mammaplasty, with various modifications formed over the years. This technique is often used in patients requiring major reduction in size, and optimization of the steps involved in the technique during the operation is of utmost importance to the plastic surgeon. Methods: We included 27 female patients who underwent mammaplasty between January 2018 and December 2020, with the modified superomedial pedicle technique. The technique of dissection is described in detail, by changing some of the steps of the pedicle dissection. We then assessed for patient satisfaction, complication rate, and operative duration, compared with a control group of 27 patients who underwent superomedial pedicle mammaplasty without the modification. Result: The use of this technique resulted in major reduction in operative time, with a similar complication rate and a high satisfaction rate among the patients. Conclusion: By changing some of the steps in the dissection of the superomedial pedicle, the surgeon can achieve optimal results and safety, with major gain in operative time reduction and surgical flexibility.

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“…5 Free nipple grafting as well as a variety of pedicled techniques were advocated for large reductions in obese patients, but the number of different approaches suggests that no single method is ideal. [6][7][8][9] The current study targets to present a series of women with macromastia who underwent bilateral reduction mammoplasty (RM) through the inferior pedicle with inverted-T (wise pattern reduction) approach and to evaluate the surgical and aesthetic outcomes and women' satisfaction 3-months postoperative (PO).…”

Section: Introductionmentioning

confidence: 99%

Inferior pedicle with inverted-T procedure for bilateral reduction mammoplasty provided satisfactory surgical and aesthetic outcome

Shod

2021

Int Surg J

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Background: The objective of the study was to evaluate surgical and aesthetic outcomes of bilateral reduction mammoplasty (RM) through the inferior pedicle with inverted-T approach (PO).Methods: 23 women with bilateral symptomatizing macromastia underwent preoperative breast measurements, calculation of breast volume (BV), determination of quality of life (QoL) and self-esteem scorings using the breast reduction assessed severity scale (BRASS) and the Rosenberg self-esteem scale (RSES). RM was performed and intraoperative and PO data were collected. At 3-m PO, aesthetic outcome was evaluated using the ABNSW score, which assesses breasts asymmetry and shape, nipple deformation, skin condition and wound scar, and QoL outcome and overall satisfaction were determined.Results: Mean operative time was 240.4±39.7 min and mean weight of excised breast tissue was 2778.3±307.7 gm. Minor PO complications were managed conservatively and no patient required revision surgery. PO breast measurements were significantly improved with decreased BV and increased breast projection. Median ABNSW score was 10 and PO median BRASS and RSES scores were 9 and 17 with significant change in comparison to preoperative data. Preoperative BRASS score was negatively correlated age and body mass index, while RSES score was positively correlated with age. Nine women were highly satisfied by aesthetic outcome, 10 women were satisfied and 16 women were highly satisfied with overall outcome.Conclusions: RM significantly improved women QoL, aesthetic appearance and psychological status. Inferior pedicle with inverted T-mammoplasty is a safe, and applicable pattern of mammoplasty, allow significant reduction of BV with improved breast measurements and projection and provide satisfactory aesthetic outcome.

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Superiomedial Pedicle Breast Reduction for Gigantic Breast Hypertrophy: Experience in 341 Breasts and Suggested Safety Modifications

Cited by 21 publications

References 39 publications

Nipple-Sparing Gigantomastia Breast Reduction

Nipple-Sparing Gigantomastia Breast Reduction

A Modified Dissection of the Superomedial Pedicle

Inferior pedicle with inverted-T procedure for bilateral reduction mammoplasty provided satisfactory surgical and aesthetic outcome

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