Modified subtotal mastectomy and free nipple graft in the treatment of severe mammary hypertrophy and ptosis.

Subtotal mastectomy using a modified Strömbeck formula for planning of the incisions, and occasionally from one to three dermofat flaps, combined with free nipple transplantation, has been applied to seven patients with severe mammary hypertrophy and ptosis. There have been no major complications, the aesthetic result is satisfactory, and the risk for later mammary cancer is minimized. The technique is recommended in severe hypertrophy and/or ptosis to overcome the increased risk of nipple necrosis of the classical reduction plasties. It may also be combined with prosthetic augmentation to substitute a subcutaneous mastectomy in only ptotic breasts.