OBTAINING PROJECTION IN THE AMPUTATION FREE NIPPLE AREOLAR GRAFT BREAST REDUCTION WITHOUT A VERTICAL SCAR - USING BREAST PARENCHYMA TO CREATE A NEW MOUND

Multiple techniques for breast reduction in the giant breast have been used, The amputation technique with the free nipple/areolar graft has been the mainstay for severe macromastia since 1921. Traditional meth ods for amputation of the inferior pole of the breast have created fai rly flat breast mounds, Projection of the mound was enhanced by an inf erior pleat with a resulting vertical scar. A new technique employing a superiorly based dermal fat flap folded back behind the residual bre ast to improve projection and roundness has been developed. It has not only eliminated the vertical scar but improved the shape of the mound . It has also given patients who were not previously goad candidates f or reduction with other techniques an option for surgery despite the p resence of old scars or the need for lumpectomy in the lower third of the breast. A clinical series is presented.