A condition called "gigantomastia" is extreme enlargement of the breasts. In many of these cases, the amount of tissue that needs to be removed and the distance that the nipple needs to travel to go into a more anatomic position, makes it impossible to keep the nipple on a vascularized pedicle. In most of these cases, surgeons use a "free nipple graft". This means that the nipple is removed at the time of reduction fo the breast mound, the breast is reduced and reshaped and the nipple is put back on to the breast mound as a full thickness skin graft. Unfortunately, this means that the function of the nipple is destroyed and in most cases, the nipple becomes insensate. During her specialty fellowship training in breast and body contouring surgery that Dr. Collins did in addition to her fellowship in plastic and reconstructive surgery, she worked with Dr. John McCraw to perfect the technique of a "Passot breast reduction". With this method, more space is allowed in the reduction pocket to accommodate the vascularized nipple pidicle. Because of this, larger breasts can be reduced without using a free nipple graft as was the case in the patient. The vertical scar is eliminated and the nipple is preserved on a vascularized pedicle. This means that the sensation and function are preserved.