Reduction Mammoplasty in Gigantomastia Using the Inferior Pedicle and Inverted-T Skin Closure: A Retrospective Study

Introduction: Gigantomastia, or breast hypertrophy, is a rare condition characterised by excessive breast tissue growth, leading to significant physical and psychological distress. Inferior pedicle reduction mammoplasty (Goldwyn & Courtiss, 1990, Plast Reconstr Surg , 255–266) is a well-established technique for addressing this condition, ensuring adequate blood supply to the nipple–areolar complex (NAC) while achieving substantial volume reduction and aesthetic improvement. Patients and Methods: This retrospective study included 35 women who underwent inferior pedicle breast reduction between 2007 and 2024. The procedure was performed using a Wise-pattern skin incision. Standard preoperative markings guided tissue resection while maintaining a well-vascularised inferior pedicle to sustain NAC viability. Results: All patients experienced a reduction in breast volume with sustained NAC sensation (Baslaim et al., 2018, Plast Reconstr Surg Glob Open , 6, e1798), breast projection and shape. The mean tissue resection ranged from 600 g to 1.2 kg per breast. Complications included bottoming-out in three patients, high positioning of the NAC in one patient and partial NAC necrosis in one patient. The average follow-up period was 12 months, with high patient satisfaction scores regarding appearance, reduction in symptoms and quality of life. Conclusion: Inferior pedicle reduction mammoplasty is a reliable and versatile technique that balances volume reduction, aesthetic outcomes and preservation of NAC vascularity. The technique provides long-term symptomatic relief and functional benefits while ensuring aesthetic harmony.