Abstract
Purpose
This study focuses on the use of round or anatomically shaped breast autoprosthesis with different volumes prepared from the central and lower poles of the breast. The technical details and surgical outcomes for patients with varying degrees of breast ptosis are discussed.
Material and Method
This study involved 42 patients who underwent the Wise-pattern superior pedicle mastopexy procedure using the adipodermaglandular island flap technique. The research spanned from December 2017 to August 2022. The study participants had not previously undergone breast surgery, did not desire breast implants, and exhibited grade 2 and 3 breast ptosis according to the Regnault Classification. Age and preoperative breast measurements of the patients were recorded for subsequent analysis. Measurements, such as the distance from the nipple–areolar complex to the inframammary fold and the distance from the suprasternal notch to the nipple–areolar complex, were taken both before the surgery and one year after. A systematic process was followed to identify acute and subacute complications during the postoperative follow-up period.
Results
This study involved 42 patients with a mean age of 33.9 years (range: 23–49 years). These procedures were conducted between December 2017 and August 2022. The average SN-N distance before surgery measured 26.7 cm (range: 24–33 cm). One year after surgery, the average SN-N distance was 23.1 cm (range: 21.3–24.8 cm). The follow-up duration for the examined cases ranged from 12 to 18 months on average. Among the observed cases, delayed wound healing was noted in one instance, venous insufficiency of the nipple in another, and fat necrosis in a third case. The overall complication rate in the group was determined to be 7.1%.
Conclusion
In our study, the detachment of dermal connections at the level of the inframammary fold (IMF) and the smooth advancement of the flap in the form of an “island flap” made a contribution to upper pole fullness. Furthermore, we hypothesize that the fusion of the medial and lateral ends of the flap will enhance tissue integration during the healing process, promoting compatibility between the autoprosthesis tissue and breast tissue. Regarding the rates of complications described, classic mastopexy techniques have exhibited similar rates in our findings.
Level of Evidence IV
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References
American Society of Plastic Surgeons (2020) Plastic surgery statistics report
Ribeiro L, Accorsi A Jr, Buss A, Marcal-Pessoa M (2002) Creation and evolution of 30 years of the inferior pedicle in reduction mammaplasties. Plast Reconstr Surg 110:960–970
Hammond DC, O’Connor EA (2014) The lower ısland flap transposition (LIFT) technique for control of the upper pole in circumvertical mastopexy. Plast Reconstr Surg 134:655–660
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 32:371–374
Daniel M (1995) Mammaplasty with pectoral muscle flap. Paper presented at: 64th annual ASPRS/PSEF/ASMS scientific meeting Montreal, Quebec
Regnault P (1976) Breast ptosis: Definition and treatment. Clin Plast Surg 3:193–203
Lassus C (1987) Breast reduction: evolution of a technique—a single vertical scar. Aesth Plast Surg 11:107–112
Lejour M (1993) Vertical mammaplasty. Plast Reconstr Surg 92:985–986
Marchac D, de Olarte G (1982) Reduction mammaplasty and correction of ptosis with a short inframammary scar. Plast Reconstr Surg 69:45–55
Fayman MS (1998) Short scar mastopexy with flap transposition. Aesthet Plast Surg 22:135–141
de la Plaza R, Cruz L (2005) Moreno mastopexy utilizing a dermoglandular hammock flap. Aesthetic Surg J 25:31–36
Hönig F, Frey HP, Hasse FM, Hasselberg J (2009) Autoaugmentation mastopexy with an inferior-based pedicle. Aesthet Plast Surg. 33(3):302–307
Sanniec K, Adams WP (2019) The tissue-based triad in augmentation mastopexy: single-stage technical refinements. Aesthet Surg J 39(12):1331–1341
Qureshi AA, Myckatyn TM, Tenenbaum MM (2018) Mastopexy and mastopexy-augmentation. Aesthet Surg J 38(4):374–384. https://doi.org/10.1093/asj/sjx181
Altınel D, Serin M, Toplu G (2022) Comparison of classic mastopexy method with double-pedicled auto augmentation mastopexy with conic-shaped modified ınferior butterfly flap. Aesthetic Plast Sur 46:1641–1649
Ors S (2018) Augmentation mastopexy with a dermal encapsulated round or anatomic autoprosthesis. Aesthetic Plast Surg 42:88–97
Zaussinger M, Wenny R, Huemer GM (2022) Auto-augmentation mastopexy: inferiorly based parenchymal flap technique and evaluation of outcomes using BREAST-Q After 151 consecutive patients. Aesthetic Plast Surg 46(6):2723–2732
Graf R, Tolazzi AR, 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. Aesthetic Surg J 36(10):1113–1121
Mangialardi ML, Ozil C, Lepage C (2021) One-stage mastopexy–lipofilling in cosmetic breast surgery: a prospective study. Aesthet Plast Surg. 45(5):1975–1985
Watfa W, Zaugg P, Baudoin J, Bramhall RJ, Raffoul W, di Summa PG (2019) Dermal triangular flaps to prevent pseudoptosis in mastopexy surgery: the hammock technique. Plast Reconstr Surg Glob Open 7(11):1–9
Atiyeh B, Ghieh F, Chahine F, Oneisi A (2022) Ptosis and bottoming out following mastopexy and reduction mammoplasty. Is syn-thetic mesh internal breast support the solution? A systematic review of the literature. Aesthet Plast Surg 46(1):25–34
Adams WP, Moses AC (2017) Use of poly-4-hydroxybutyrate mesh to optimize soft-tissue support in mastopexy: a single-site study. Plast Reconstr Surg 139(1):67–75
De Bruijn HP, Johannes S (2008) Mastopexy with 3D preshaped mesh for long-term results: development of the internal bra system. Aesthet Plast Surg. 32(5):757–765
Persichetti P, Simone P, Palazzolo D, Carusi C (2012) Reduction of the opposite breast in patients with a breast reconstructed with an implant: validity of the inverted “t”, superior pedicle technique, with an inferiorly-based dermal adipose flap. J Plast Surg Hand Surg 46(5):339–343
Kemaloglu CA, Özocak H (2018) Comparative outcomes of inferior pedicle and superomedial pedicle technique with wise pattern reduction in gigantomastic patients. Ann Plast Surg 80(3):217–222
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Duran, A., Cortuk, O. & Eroglu, S. Round Autoprosthesis: Use of Adipodermaglandular Flap in T Scar Mastopexy. Aesth Plast Surg (2024). https://doi.org/10.1007/s00266-024-03909-2
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DOI: https://doi.org/10.1007/s00266-024-03909-2