Enormous Breast Reduction with Free Nipple Grafts in High- Patient, NC*

Free nipple graft technique is a type of breast reduction frequently done in massive reductions when the blood supply of the nipple cannot be supported by a standard pedicle. A pedicle is the breast tissue pattern that is preserved and keeps the nipple alive. In patients with medical problems, obesity and very large size breasts , the reliability of the blood flow is suspect and survival of the nipple as a full-thickness skin graft is actually more successful -not relying on deep blood flow. This 29-year-old woman had multiple risk factors including SLE or lupus for which she took hydroxychloroquine. She suffered open sores on her breasts and had very large oversized breasts. She also had severe back pain and neck pain and could not find an appropriate brassiere. She was morbidly obese with a body mass index of 42. She was clearly suffering and although at high risk,it was felt that a breast reduction would definitely help her issues. She underwent breast reduction with removal of 6.8 pounds from the right breast and 7.7 pounds from the left breast. A total of 14.5 pounds! She stayed in the hospital for 2 days postoperatively for antibiotics. She healed very well. The nipples survived totally although typically, re-pigmentation of the dark areola takes up to a year. She was very pleased with the improvements and neck and back pain and no longer suffered open sores. Despite her high risk she did well with this very large breast reduction.