{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T16:26:42Z","timestamp":1776356802664,"version":"3.51.2"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Optimal reduction mammoplasty techniques to treat patients with gigantomastia have been debated and can involve extended pedicles (EP) or free nipple grafts (FNG).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The authors compared clinical, patient-reported, and aesthetic outcomes associated with reduction mammoplasty employing EP vs FNG.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A multi-institutional, retrospective study of adult patients with gigantomastia who underwent reduction mammoplasty at 2 tertiary care centers from 2017 to 2020 was performed. Gigantomastia was defined as reduction weight &amp;gt;1500 g per breast or sternal notch-to-nipple distance \u226540 cm. Surgeons at 1 institution employed the EP technique, whereas those at the other utilized FNG. Baseline characteristics, preoperative and postoperative BREAST-Q, and clinical outcomes were collected. Aesthetic outcomes were assessed in 1:1 propensity score-matched cases across techniques. Preoperative and postoperative photographs were provided to reviewers across the academic plastic surgery continuum (students to faculty) and non-medical individuals to evaluate aesthetic outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Fifty-two patients met the inclusion criteria (21 FNG, 31 EP). FNG patients had a higher incidence of postoperative cellulitis (23% vs 0%, P &amp;lt; 0.05) but no other differences in surgical or medical complications. Baseline BREAST-Q scores did not differ between groups. Postoperative BREAST-Q scores revealed greater satisfaction with the EP technique (P &amp;lt; 0.01). The aesthetic assessment of outcomes in 14 matched pairs of patients found significantly better aesthetic outcomes in all domains with the EP procedure (P &amp;lt; 0.05), independent of institution or surgical experience.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This multi-institutional study suggests that, compared with FNG, the EP technique for reduction mammoplasty provides superior clinical, patient-reported, and aesthetic outcomes for patients with gigantomastia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of Evidence: 4<\/jats:title>\n                  <jats:p\/>\n               <\/jats:sec>","DOI":"10.1093\/asj\/sjac258","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T09:18:39Z","timestamp":1664183919000},"page":"NP91-NP99","source":"Crossref","is-referenced-by-count":12,"title":["Outcomes of Extended Pedicle Technique vs Free Nipple Graft Reduction Mammoplasty for Patients With Gigantomastia"],"prefix":"10.1093","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0912-458X","authenticated-orcid":false,"given":"Ankoor A","family":"Talwar","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, University of Pennsylvania , Philadelphia, PA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Libby R","family":"Copeland-Halperin","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, The Brigham and Women's Hospital , Boston, MA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Landis R","family":"Walsh","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, Zucker School of Medicine at Hofstra\/Northwell , New Hyde Park, NY , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrienne N","family":"Christopher","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, University of Pennsylvania , Philadelphia, PA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5247-3553","authenticated-orcid":false,"given":"Jessica","family":"Cunning","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, University of Pennsylvania , Philadelphia, PA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robyn B","family":"Broach","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, University of Pennsylvania , Philadelphia, PA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D","family":"Baratta","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, Dartmouth-Hitchcock Medical Center , Lebanon, NH , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Copeland","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, Mount Sinai Health System , New York, NY , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vidya","family":"Shankaran","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, Dartmouth-Hitchcock Medical Center , Lebanon, NH , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paris D","family":"Butler","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, Yale School of Medicine , New Haven, CT , 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