Use of the back-folded dermaglandular inferior pedicle in mammary amputation: improving results

Autor: Wellerson Marcos Mattioli, Sergio Augusto Penazzi Júnior, David Silveira Farias de Melo
Jazyk: English<br />Portuguese
Rok vydání: 2017
Předmět:
Zdroj: Revista Brasileira de Cirurgia Plástica, Vol 32, Iss 03, Pp 340-345 (2017)
Druh dokumentu: article
ISSN: 1983-5175
2177-1235
DOI: 10.5935/2177-1235.2017RBCP0057
Popis: INTRODUCTION: Patients with gigantomastia have multiple physical and psychosocial symptoms. Various techniques have been proposed for their treatment. Described by Torek in 1922, mammary amputation was presented as a great alternative, but resulted in reduced mammillary functionality and loss of breast format. In 1975, Liacyr Ribeiro described the use of dermaglandular inferior pedicle as safety tissue to allow for mammary resection, to facilitate breast assembly and to improve projection. The author proposed to unite these two consolidated techniques with the intention of improving breast amputation outcomes. METHODS: Eleven gigantomastia patients were operated on by means of the amputation technique using dermaglandular inferior pedicle. RESULTS: The mean distance between the sternal notch and the nipple was 35.6 cm for the right breast and 35 cm for the left breast, with all measures ranging between 30 cm and 44 cm. Rise of the nipple-areola complex was in average 16.9 cm for the right breast and 16.4 cm for the left breast, varying from 12 to 25 cm. The amount of breast tissue resection per patient was, in average, 3559.5 grams, ranging from 1600 grams to 5890 grams. Hypopigmentation of the nipple-areola complex was present in three patients (27%). Dehiscence of the T was observed in two patients (18%). Partial non-integration of the graft occurred in three patients (27%), with loses estimated at 10%, 30% and 80% of the graft. CONCLUSION: Associating mammary amputation with an inferior dermaglandular pedicle provides good remodeling and safe assembling of the breast, in addition to providing proper projection.
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