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Aesthetic Plastic Surgery

, Volume 42, Issue 5, pp 1202–1212 | Cite as

Reverse-Muscle Sling Reduces Complications in Revisional Mastopexy–Augmentation

  • Denis Souto ValenteEmail author
Original Article Breast Surgery

Abstract

Background

Simultaneous augmentation–mastopexy is a particularly tricky operation with a considerable reoperation rate. The pectoralis muscle sling has proven to be a suitable alternative technique for long-term results in breast parenchyma suspension without silicone implants. This study aims to propose a promising approach to simultaneous augmentation–mastopexy revisional surgery using an inverted dual-plane technique acting as a muscular sling.

Methods

A 10-year historic cohort was conducted to obtain the following variables from our preexisting database: age, preoperative measurements, operative technicalities, implant details, time from procedure to revision, complications, and outcomes.

Results

Twenty-six patients assessed after the initial postoperative year were analyzed. Review of this series of patients revealed a revision rate of 3.8% and overall rate of morbidity of 11.5%.

Conclusion

Simultaneous augmentation–mastopexy using an inverted dual-plane technique acting as a muscular sling is a reliable and safe procedure. Review of this series of patients revealed low rates of morbidity and reoperation need.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Keywords

Revisional surgery Augmentation mastopexy Breast augmentation Breast lift Round breast Mastopexy Silicone implants 

Notes

Compliance with Ethical Standards

Conflict of interest

The author does not have any commercial associations or financial disclosures that might pose or create a conflict of interest with information or medical devices presented in this submitted manuscript. There are no conflicts of interest in this research.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Supplementary material

Video 1: Trans operative surgical technique (MP4 72187 kb)

Video 2: Breast dynamics 4 years after augmentation–mastopexy with muscular sling (MP4 26427 kb)

References

  1. 1.
    Spear SL, Boehmler JH, Clemens MW (2006) Augmentation/mastopexy: a 3-year review of a single surgeon’s practice. Plast Reconstr Surg 118:136S–1347SCrossRefPubMedGoogle Scholar
  2. 2.
    Pozner JN, White JB, Newman MI (2013) Use of porcine acellular dermal matrix in revisionary cosmetic breast augmentation. Aesthet Surg J 33:681–690CrossRefPubMedGoogle Scholar
  3. 3.
    Spring MA, Hartmann EC, Stevens WG (2015) Strategies and challenges in simultaneous augmentation mastopexy. Clin Plast Surg 42:505–518CrossRefPubMedGoogle Scholar
  4. 4.
    Khavanin N, Jordan SW, Rambachan A, Kim JY (2014) A systematic review of single-stage augmentation–mastopexy. Plast Reconstr Surg 134:922–931CrossRefPubMedGoogle Scholar
  5. 5.
    Graf R, Tolazzi ARD, Balbinot P, Pazio A, Valente PM, Freitas RS (2016) Influence of the pectoralis major muscle sling in chest wall-based flap suspension after vertical mammaplasty: ten-year follow-up. Aesthet Surg J 36:1113–1121CrossRefPubMedGoogle Scholar
  6. 6.
    Lazarus D (1998) A new template-goniometer for marking the Wise keyhole pattern of reduction mammoplasty. Plast Reconstr Surg 101:171–173CrossRefPubMedGoogle Scholar
  7. 7.
    Valente DS (2014) Preemptive analgesia with bupivacaine in reduction mammoplasty: a prospective, randomized, double-blind, placebo-controlled trial. Plast Reconstr Surg 134:581–586CrossRefPubMedGoogle Scholar
  8. 8.
    Maclin MM, Deigni OA, Bengtson BP (2015) The laminated nature of the pectoralis major muscle and the redefinition of the inframammary fold: clinical implications in aesthetic and reconstructive breast surgery. Clin Plast Surg 42(4):465–479CrossRefPubMedGoogle Scholar
  9. 9.
    Seify H, Ismail K, Evans G (2010) Primary augmentation/mastopexy using large implants: is it a safe technique? A 4-year single surgeon review. Plast Reconstr Surg 126:67–68CrossRefGoogle Scholar
  10. 10.
    Swanson E (2013) Prospective comparative clinical evaluation of 784 consecutive cases of breast augmentation and vertical mammoplasty, performed individually and in combination. Plast Reconstr Surg 132:30e–45eCrossRefPubMedGoogle Scholar
  11. 11.
    Calobrace MB, Herdt DR, Cothron KJ (2013) Simultaneous augmentation/mastopexy: a retrospective 5-year review of 332 consecutive cases. Plast Reconstr Surg 131:145–156CrossRefPubMedGoogle Scholar
  12. 12.
    Doshier LJ, Eagan SL, Shock LA, Henry SL, Colbert SH, Puckett CL (2016) The subtleties of success in simultaneous augmentation–mastopexy. Plast Reconstr Surg 138:585–592CrossRefPubMedGoogle Scholar
  13. 13.
    Stevens WG, Spring M, Stoker DA, Freeman ME, Cohen R, Quardt SM, Hirsch EM (2007) A review of 100 consecutive secondary augmentation/mastopexies. Aesthet Surg J 27:485–492CrossRefPubMedGoogle Scholar
  14. 14.
    Spring MA, Macias LH, Nadeau M, Stevens WG (2014) Secondary augmentation–mastopexy: indications, preferred practices, and the treatment of complications. Aesthet Surg J 34:1018–1040CrossRefPubMedGoogle Scholar
  15. 15.
    Gonzalles-Ulloa M (1960) Correction of hypotrophy of the breast by means of exogenous material. Plast Reconstr Surg 25:15–26CrossRefGoogle Scholar
  16. 16.
    Hidalgo DA, Spector JA (2013) Mastopexy. Plast Reconstr Surg 132:642e–656eCrossRefPubMedGoogle Scholar
  17. 17.
    Spear SL, Low M, Ducic I (2003) Revision augmentation mastopexy: indications, operations, and outcomes. Ann Plast Surg 51:540–546CrossRefPubMedGoogle Scholar
  18. 18.
    Choi M, Unger J, Small K, Tepper O, Kumar N, Feldman D, Karp N (2009) Defining the kinetics of breast pseudoptosis after reduction mammoplasty. Ann Plast Surg 62:518–522CrossRefPubMedGoogle Scholar
  19. 19.
    Frame J (2017) The waterfall effect in breast augmentation. Gland Surg 6:193–202CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Tebbetts JB (2006) Dual plane breast augmentation: optimizing implant-soft-tissue relationships in a wide range of breast types. Plast Reconstr Surg 118:81S–98SCrossRefPubMedGoogle Scholar
  21. 21.
    Neto LG, Reis de Araújo LR, Baggio M, Broer PN, Graf R (2013) The Ruth Graf technique in secondary mammoplasty. Plast Reconstr Surg 131:125e–127eCrossRefPubMedGoogle Scholar
  22. 22.
    Auersvald A, Auersvald LA (2011) Breast augmentation and mastopexy using a pectoral muscle loop. Aesthetic Plast Surg 35:333–340CrossRefPubMedGoogle Scholar
  23. 23.
    Biggs TM, Graf R, Taneja A (2003) Maintaining shape in mastopexy. Aesthet Surg J 23:391–392CrossRefPubMedGoogle Scholar
  24. 24.
    Graf RM, Mansur AE, Tenius FP, Ono MC, Romano GG, Cruz GA (2008) Mastopexy after massive weight loss: extended chest wall-based flap associated with a loop of pectoralis muscle. Aesthetic Plast Surg 32:371–374CrossRefPubMedGoogle Scholar
  25. 25.
    Vita RD, Zoccali G, Buccheri EM (2017) The Balcony technique of breast augmentation and inverted-T mastopexy with an inferior dermoglandular Flap. Aesthetic Surg J 37:1114–1123CrossRefGoogle Scholar
  26. 26.
    Tebbetts JB (2014) A process for quantifying aesthetic and functional breast surgery: II. Applying quantified dimensions of the skin envelope to design and preoperative planning for mastopexy and breast reduction. Plast Reconstr Surg 133:527–542CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  1. 1.Graduate Program in Medicine and Health Sciences School of Medicine PUCRSPorto AlegreBrazil

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