ReviewJPRAS open2025
Sensory preservation in reduction mammoplasty using the nipple-areola complex-carrying pedicle technique for gigantomastia: A systematic review and meta-analysis.
Review in JPRAS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
Funding
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Abstract
Background: Gigantomastia is a disabling condition characterized by excess breast tissue. Historically, free nipple graft (FNG) has been preferred, prioritizing the nipple-areola complex (NAC) vascularity. The NAC-carrying pedicle technique, which is most commonly used in case of hypertrophy of the breast, has been suggested as a viable alternative for gigantomastia according to recent evidence, with reduced rates of NAC necrosis and improved outcomes. Nevertheless, a detailed outcome evaluation of the technique in terms of sensory preservation is currently lacking. Therefore, this systematic review and meta-analysis aimed to assess the risk of sensory loss associated with the NAC-carrying pedicle technique in cases of gigantomastia. Methods: Following the PRISMA guidelines, a literature search identified studies reporting postoperative sensitivity with the NAC-carrying pedicle technique in resections exceeding 1000 g of adipo-glandular tissue. Then, a proportion meta-analysis was conducted to assess the pooled rate of sensation loss through the NAC-carrying pedicle technique. Results: Seventeen studies (843 patients, 1685 breasts) met the inclusion criteria. The meta-analysis revealed an exceptionally low risk of sensory loss with the NAC-carrying pedicle technique (1.3%; 95% confidence interval: 0.7-2.0), without significant statistical heterogeneity. Conclusion: This study provides the first comprehensive evaluation of sensory preservation with the NAC-carrying pedicle technique in gigantomastia. The NAC-carrying pedicle technique emerges as the first choice, offering safety and favorable functional outcomes. Surgical caution remains crucial with the option to switch to FNG as required, ensuring patient safety and procedure success. Further research on the impact of different NAC-carrying pedicle techniques on sensory preservation is warranted.
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