Postoperative measures changes in patients with gigantomastia who underwent inverted-T reduction mammoplasty with or without dermo-adipo-glandular inferior-pedicled Ribeiro flap.

Abstract

The Ribeiro flap was originally described to increase breast projection during breast surgery. The aim of the study was to evaluate the changes in breasts of patients with gigantomastia undergoing reduction mammaplasty with a Pitanguy-Ribeiro technique based on the Ribeiro flap and compare volume, sternal notch-nipple, sulcus-nipple distance, and projected sulcus-to-skin distance-sulcus with a control group (without the use of the aforementioned flap). The flap group was composed of 33 patients, while the no-flap group was composed of 52 patients. Photographs and measurements were taken preoperatively and after 3, 6, and 12 months. The estimated volume was calculated using BREAST-V. Groups were comparable for breast volume after surgery. The ANOVA test showed significant increases in outcome measurements between each time in each single group. The t-test didn't demonstrate a statistically significant change for ΔT12-3 between the two groups for each outcome. The average T3 projection in the flap group was greater. A weak negative correlation between projection and ΔT0-3 volumes within the flap group was demonstrated. Authors may assume that for both groups, breasts tend to descend over time with no significant difference between the two groups. The flap allowed an increased breast projection, which can be influenced by tissue resection. The use of the Ribeiro flap during reduction mammoplasty according to Pitanguy's technique seems not to affect the stability of the breast over time in patients with gigantomastia. The flap and extent of tissue resection appear to influence postoperative breast projection.