Comparision of free nipple technique and superiomedial pedicle technique for reduction mammaplasty in gigantomastia applied in our clinic

Aim: The aim of this study is to show which technique is appropriate to use in which patient for breast reduction mammaplasty in gigantomastia with comparison of free nipple graft technique and superomedial pedicle technique that are administered to patients in our clinic.Materials and Methods: For this purpose, retrospectively; reached 118 patients with Gigantomastia in 220 patients which has done reduction mammaplasty between June 2006 - 2011. 67 of the patients were operated with free nipple graft technique, 51 of the patients were operated with the superomedial pedicle breast reduction technique. All patients are recorded with; age, height, weight, body mass index (BMI), number of births, socio - cultural level, occupation, the additional presence of systemic disease, smoking, preoperative measurements obtained from the right and the left nipple, the areola from the sternal notch distance, and the right time perop the left breast removed before the use of formalin weight of the total tissue amount, postoperative sternal notch nipple areola distance, operation time, hospital stay, complications, and if secondary intervention has done or not. Satisfaction of the patients was graded over five.Findings: 81.4% of the patients was housewives, 82.2% percent had moderate, and low socioeconomic level. Average age found 47.3 ± 10.7 in Group I Patients, and 37.4 ± 11.5 in Group II patients. Group I patients with average BMI of 37.1 ± 6.0 kg / m2, while patients in Group II, 32.1 ± 5.4 kg / m2 found. When we look at additional disease rates; in 38.8% of Group I patients, and, in 15.7% of Group II patients, the presence of systemic disease was detected. These rates were found statistically significant. A total amount of tissue resected from Group I patients were found to be 3636.2 ± 1038.4 grams, and a total amount of tissue resected from Group II patients were found to be 2324.8 ± 450.6 grams. Looking at satisfaction and complication rates there was no significant difference in both groups. In Group II, four-areola necrosis occurred. Systemic complications didn't occur in any of the patient in this study.Conclusion: When deciding on the method of choice in patients with gigantomastia, which there is the need of tissue resection over 1000 g from one breast; the patient's age, BMI, the presence of additional disease, to be in postmenopausal period, should be considered. Our clinic recommend the use of the technique of free nipple reduction, in patients; over 40 years, who is in the postmenopausal period, who's BMI is over 30 and who has additional systemic disease; without any doubt. In other conditions; superomedial pedicle breast reduction technique is quite safe to apply to get more permanent long-term functional and aesthetic results.Key Words: Mammary hypertrophy, gigantomastia, free nipple graft reduction mammaplasty, superomedial pedicle reduction mammaplasty.