Hybrid Inferior Pedicle Reduction Mammaplasty with Free Nipple Grafts in a Patient with Gigantomastia

Summary:. Gigantomastia presents a unique set of challenges for preservation of the nipple–areola complex in patients undergoing reduction mammaplasty. Historically an indication for breast amputation and free nipple graft (FNG), gigantomastia is now commonly treated using pedicle-based reconstruction. We present a case combining these two surgical techniques, using an inferior-pedicle reduction with an FNG in the management of extreme breast hypertrophy with 11,300 g in total resected. This case report shows that such a technique for gigantomastia reductions can combine the aesthetic benefits of a pedicled reduction with the reliability of FNGs. These benefits make the hybrid inferior pedicle reduction a useful option, which should be present in every plastic surgeon’s armamentarium when caring for these patients.