Does the reductive mastopexy with implant approach prevent the late bottoming out?
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After breast surgery, the late upward rotation of the nipple–areola complex and the increased of the fullness at the lower pole of the breast have been defined as a Bottoming out. Although several studies have focused on the safety and complication rate of the one-stage augmentation/mastopexy, there is no clear recommendation how to prevent the late complication of “bottoming out”.
A retrospective review was conducted of 48 consecutive patients who underwent one-stage mastopexy/augmentation using the reductive approach. Data collected included the following: patient's characteristics implant information, operative technique and postoperative results. Complication and revision rates were assessed to determine the efficacy of the reductive mastopexy/augmentation.
All patients (N = 48) were available for follow-up, an average 18 months postoperatively. Overall complication rate was 14.5%. No severe complications were recorded. The most common complication was wound separation (2), followed by capsular contracture (2), and bottoming out (1). Seven patients (14.5%) underwent some form of revision surgery following the one-stage procedure. The revision rate due to bottoming out was 2.2%.
When performing the one-stage augmentation/mastopexy procedure, using the reductive mastopexy approach does effectively reduce the internal tension from the lower pole of the breast and helps to prevent the occurrence of bottoming out.
Level of Evidence: Level IV, therapeutic study
KeywordsBottoming out Silicone implant One-stage mastopexy with implant Ptosis recurrence Reduction mastopexy with implant
The authors thank Mr. E. Latimer-Sayer and Dr. M. Shiffman for the careful reviewing of the manuscript and constructive comments.
Conflict of interest
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