Medial Pedicle Wise-pattern Breast Reduction for Gigantomastia: A Single-center Retrospective Review
Background:. Gigantomastia causes severe back pain, postural imbalance, intertrigo, and psychosocial disablement. Multiple breast reduction techniques exist. Breast reduction with free nipple graft reconstruction is the preferred treatment. We found that the medial pedicle Wise-pattern (MPWP) techni...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-08-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005170 |
| _version_ | 1797732773221367808 |
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| author | Chandler Hinson, MBA, MSc Victoria Bouillon, MD Ronald Brooks, MD, FACS |
| author_facet | Chandler Hinson, MBA, MSc Victoria Bouillon, MD Ronald Brooks, MD, FACS |
| author_sort | Chandler Hinson, MBA, MSc |
| collection | DOAJ |
| description | Background:. Gigantomastia causes severe back pain, postural imbalance, intertrigo, and psychosocial disablement. Multiple breast reduction techniques exist. Breast reduction with free nipple graft reconstruction is the preferred treatment. We found that the medial pedicle Wise-pattern (MPWP) technique is an equally safe and effective technique.
Methods:. Review of our institution’s electronic medical record between February 2020 and February 2023 identified women with gigantomastia who underwent bilateral reduction with more than 1500 g resected in at least one breast. Multinomial logistical regressions were used to identify associations between comorbidities, operative techniques, postoperative complications, and nipple areolar complex function.
Results:. Thirty-one patients underwent bilateral reduction mammaplasty. Total bilateral resection weight and average body mass index (BMI) were 3828 g and 40 kg per m2. Common comorbidities were hypertension (38%) and tobacco use (26%). MPWP was used predominantly (65%), followed by inferior pedicle (16%) and superior-medial pedicle (10%). Complications included loss of nipple areolar complex sensation (23%) and wound dehiscence (16%). Reduction technique was not associated with increased surgical complications (odds ratio = 0.75, P = 0.273). Age, excision amount, use of postsurgical drains, and BMI were not associated with increased complications (P = 0.29, P = 0.55, P = 0.74, P = 0.41). Rates of areolar sensation loss were higher in larger BMIs, but this was not statistically significant (P = 0.051).
Conclusions:. The MPWP reduction technique is an equally safe and effective treatment of gigantomastia when compared with reduction with free nipple graft reconstruction. There is the added benefit of preserved nipple sensation without increased postoperative complications. |
| first_indexed | 2024-03-12T12:18:23Z |
| format | Article |
| id | doaj.art-1896661f951943c18b6d19034723af99 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-12T12:18:23Z |
| publishDate | 2023-08-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-1896661f951943c18b6d19034723af992023-08-30T06:13:49ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-08-01118e517010.1097/GOX.0000000000005170202308000-00015Medial Pedicle Wise-pattern Breast Reduction for Gigantomastia: A Single-center Retrospective ReviewChandler Hinson, MBA, MSc0Victoria Bouillon, MD1Ronald Brooks, MD, FACS2From the * Frederick P. Whiddon College of Medicine, University of South Alabama, Mobile, Ala.From the * Frederick P. Whiddon College of Medicine, University of South Alabama, Mobile, Ala.From the * Frederick P. Whiddon College of Medicine, University of South Alabama, Mobile, Ala.Background:. Gigantomastia causes severe back pain, postural imbalance, intertrigo, and psychosocial disablement. Multiple breast reduction techniques exist. Breast reduction with free nipple graft reconstruction is the preferred treatment. We found that the medial pedicle Wise-pattern (MPWP) technique is an equally safe and effective technique. Methods:. Review of our institution’s electronic medical record between February 2020 and February 2023 identified women with gigantomastia who underwent bilateral reduction with more than 1500 g resected in at least one breast. Multinomial logistical regressions were used to identify associations between comorbidities, operative techniques, postoperative complications, and nipple areolar complex function. Results:. Thirty-one patients underwent bilateral reduction mammaplasty. Total bilateral resection weight and average body mass index (BMI) were 3828 g and 40 kg per m2. Common comorbidities were hypertension (38%) and tobacco use (26%). MPWP was used predominantly (65%), followed by inferior pedicle (16%) and superior-medial pedicle (10%). Complications included loss of nipple areolar complex sensation (23%) and wound dehiscence (16%). Reduction technique was not associated with increased surgical complications (odds ratio = 0.75, P = 0.273). Age, excision amount, use of postsurgical drains, and BMI were not associated with increased complications (P = 0.29, P = 0.55, P = 0.74, P = 0.41). Rates of areolar sensation loss were higher in larger BMIs, but this was not statistically significant (P = 0.051). Conclusions:. The MPWP reduction technique is an equally safe and effective treatment of gigantomastia when compared with reduction with free nipple graft reconstruction. There is the added benefit of preserved nipple sensation without increased postoperative complications.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005170 |
| spellingShingle | Chandler Hinson, MBA, MSc Victoria Bouillon, MD Ronald Brooks, MD, FACS Medial Pedicle Wise-pattern Breast Reduction for Gigantomastia: A Single-center Retrospective Review Plastic and Reconstructive Surgery, Global Open |
| title | Medial Pedicle Wise-pattern Breast Reduction for Gigantomastia: A Single-center Retrospective Review |
| title_full | Medial Pedicle Wise-pattern Breast Reduction for Gigantomastia: A Single-center Retrospective Review |
| title_fullStr | Medial Pedicle Wise-pattern Breast Reduction for Gigantomastia: A Single-center Retrospective Review |
| title_full_unstemmed | Medial Pedicle Wise-pattern Breast Reduction for Gigantomastia: A Single-center Retrospective Review |
| title_short | Medial Pedicle Wise-pattern Breast Reduction for Gigantomastia: A Single-center Retrospective Review |
| title_sort | medial pedicle wise pattern breast reduction for gigantomastia a single center retrospective review |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005170 |
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