Breast Surgery pp 691-697 | Cite as

Augmentation Mastoplasty with Silicone Implant Associated with Mastopexy via an Initial Periareolar Approach (Safety Pocket)

  • Ataliba Ronan Horta de AlmeidaEmail author
  • André Villani Correa Mafra
  • Leandro Ramalho Chaves Isobe


Background: Mastopexy with breast implant surgery is a challenging and highly complex surgical procedure. In Brazil, there is growing interest in larger breast volumes, although in certain cases, the sole addition of silicone implants is not sufficient to construct a conical breast with a full upper pole. To obtain this result, it is necessary to correct sagging breasts by removing excess skin.

Methods: The initial approach was made with an inferior, semicircular, periareolar incision, which provided subfascial access to the breast pocket for inclusion of the implant. After implant placement, the excess skin was marked using simple stitches and staining with methylene blue before resection. Longitudinal spindle marking was preferred whenever possible. However, “L” or inverted “T” markings were also used when excess skin amounts were greater.

Conclusions: The conservative skin removal approach after prosthesis implantation, periareolar access, and use of the subfascial plane are the differential and relevant points of this technique. This technique is also considered safer because the periareolar incision caused the only loss of continuity in the tissues. Therefore, the prosthesis was not exposed during mastopexy.


Mammaplasty Breast/surgery Breast implantation 

Suggested Reading

  1. Carramaschi FR, Tanaka MP (2003) Mastopexia associada à inclusão de prótese mamária. Rev Soc Bras Cir Plást 18(1):25–36Google Scholar
  2. Chem RC (1991) Plástica mamária estética de aumento com a utilização de próteses. Rev Soc Bras Cir Plást. 6(1/2):28–32Google Scholar
  3. Gomes RS (2008) Mastopexia com retalho de pedículo superior e implante de silicone. Rev Bras Cir Plást 23(4):241–247Google Scholar
  4. Gonzalez-Ulloa M (1960) Correction of hypotrophy of the breast by means of exogenous material 25(1):15–40Google Scholar
  5. Graf RM, Bernardes A, Rippel R, Araujo LR, Damasio RC, Auersvald A (2003) Subfascial breast implant: a new procedure 111(2):904–908Google Scholar
  6. Mansur JRB, Bozola AR (2009) Mastopexia e aumento das mamas com proteção e suporte inferior da prótese com retalho de pedículo inferior. Rev Bras Cir Plást 24(3):304–309Google Scholar
  7. Pitanguy I, Carreirão S, Mazzarone F, Fróes LB, Cló TT (1991) Mastopexia associada à inclusão de prótese. Rev Soc Bras Cir Plást 81(2):101–111Google Scholar
  8. Regnault P (1966) The hypoplastic and ptotic breast: a combined operation with prosthetic augmentation 37(1):31–37Google Scholar
  9. Regnault P (1976) Breast ptosis. Definition and treatment. Clin Plast Surg 3(2):193–203PubMedGoogle Scholar
  10. Sanchéz J, Carvalho AC, Erazo P (2008) Mastopexia com prótese: técnica em “D” espelhado. Rev Bras Cir Plást 23(3):200–206Google Scholar
  11. Soares AB, Franco FF, Rosim ET, Renó BA, Hachmann JOPA, Guidi MC et al (2011) Mastopexia com uso de implantes associados a retalho de músculo peitoral maior: técnica utilizada na disciplina de cirurgia plástica da unicamp. Rev Bras Cir Plást 26(4):659–663CrossRefGoogle Scholar
  12. Spear S (2003) Augmentation/mastopexy: “surgeon, beware” 112(3):905–906Google Scholar
  13. Spear SL, Pelletiere CV, Menon N (2004) One-stage augmentation combined with mastopexy: aesthetic results and patient satisfaction. Aesthetic Plast Surg 28(5):259–267CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Ataliba Ronan Horta de Almeida
    • 1
    • 2
    Email author
  • André Villani Correa Mafra
    • 3
    • 1
  • Leandro Ramalho Chaves Isobe
    • 3
    • 1
  1. 1.Sociedade Brasileira de Cirurgia Plástica (Brazilian Society of Plastic Surgery–SBCP), Plastic Surgery Training Center, Hospital Mater Dei (Mater Dei Hospital)Belo HorizonteBrazil
  2. 2.Plastic Surgery Medical Center, Hospital Mater Dei (Mater Dei Hospital)Belo HorizonteBrazil
  3. 3.SBCP, Plastic Surgery Medical Team, Hospital Mater Dei (Mater Dei Hospital)Belo HorizonteBrazil

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