Gigantomastia is a disabling condition for patients and presents unique challenges to plastic surgeons. Presentation can occur throughout different phases of life, and treatment often begins with nonoperative measures; however, the most effective way to relieve symptoms is surgical breast reduction. Because of the large amount of tissue removed, surgeons can encounter different intraoperative and postoperative complications. By understanding this disease process and these complications, surgeons can attempt to minimize their occurrences. The authors present an overview of the cause, preoperative evaluation, techniques, and outcomes. Additionally, they present outcomes data from their center on 40 patients.
Key points
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Gigantomastia represents extreme hypertrophy of the female breast.
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Although there is no universally accepted definition, the amount of tissue resected during reduction mammaplasty is the most widely used description, with threshold ranges reported between 1000 g and 2000 g per breast.
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Gigantomastia is a complicated problem that presents unique challenges. Understanding the cause of the disease and the necessary preoperative workup will minimize complications from the operation.
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There are multiple surgical approaches for correcting gigantomastia. Although there is not one best approach, many standard approaches can be adapted with an understanding of how to maintain blood supply to the nipple/areolar complex.
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As a general guideline, a pedicle width (when pedicles are used) of at least 8 cm should be maintained with a pedicle length no more than twice that of the width.
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