The Outcome of Reduction Mammoplasty for Gigantomastia Using Inferior Pedicle: Case Series.

Introduction: Gigantomastia is a rare but not uncommon condition, and the most common surgical reduction procedure is by breast amputation with nipple-areolar grafting. Pedicle-based breast reduction is not commonly undertaken for such conditions.

Aim: This is a report of our experience in the use of an inferior-based pedicle for the reduction of gigantomastia.

Methods: Patients who had reduction mammoplasty between 2004 and 2023 were reviewed. The information obtained from their case notes included age, family history of breast enlargement, presenting features, height, weight, marital status, parity, type of resection, the length of the pedicle, the weight of tissue excised and outcome of the surgery.

Results: A total of 15 patients with gigantomastia were operated. Their age ranged from 16 years to 50 years and a mean of 29.13 ± 9.39 years. The symptoms were: feeling heavy around the chest, back and shoulder pain, not having an appropriate brassiere to wear and lack of self-confidence with low self-esteem The total resection weight (RW) for each patient ranged from 2.2 kg to 10 kg with the mean of 4.71 ± 2.23 kg. The mean body mass index (BMI) was 30.70 ± 9.08 kg/M2, and the average nipple-to-inframammary fold distance was 27.75 ± 6.74 cm on the right and 26.13 ± 5.37 cm on the left. The complications that were observed were delayed wound healing in six (40%), partial wound dehiscence in three (13%), flap necrosis with bilateral loss of nipple-areolar complex (NAC) in one (7%) and unilateral loss of NAC in one (7%). All the patients had good healing with intact NAC except for two patients.

Conclusions: Breast reduction using an inferior pedicle can be one with very good outcomes. The length of the pedicle may be a source of concern for the survival of the NAC using a broad wider base of the pedicle prevents this if properly designed.