Modified free nipple graft reduction mammaplasty to increase breast projection with superior and inferior dermoglandular flaps.

Classic free nipple graft reduction mammaplasty often yields flat, boxy breasts with poor projection. The authors modified this technique using superior and inferior pyramidal dermoglandular flaps to increase the fullness and projection of the breast. Six patients (12 breasts) with gigantomastia underwent breast reduction by this method. The results were aesthetically pleasing, with conically shaped breasts and good projection. The technique is easy to perform and it is possible to switch from pedicled nipple-areolar transposition to this method intraoperatively in patients in whom perfusion of the nipple is questionable.