Short Scar Mastopexy with Flap Transposition: The Concept of the Biological Implant in Cosmetic Breast Surgery

  • Moshe S. Fayman

The goal of mastopexy is defined as reconstructing an aesthetically pleasing breast by remodeling the breast mound, by repositioning the nipple—areola complex (NAC) in an appropriate position, and by reducing a large areola to a proportionate size. The use of breast tissue as a biological implant is a novel idea that entrusts the surgeon with a powerful tool to sculpt the contour of the breast. The concept can be applied in various manners to obtain specific aesthetic goals.


Breast Reduction Vertical Scar Inferior Pedicle Periareolar Incision Breast Ptosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Dedication and Acknowledgments

This work is dedicated with love to my wife, Mirry, the wind beneath my wings. The author gratefully acknowledges the Medical art work skillfully performed by Dr. Estelle Potgieter and Ms. Dana Fayman.


  1. 1.
    Regnault P: Breast ptosis: Definition and treatment. Clin Plast Surg 1976;3(2):193–203PubMedGoogle Scholar
  2. 2.
    Brink R: Management of true ptosis of the breast. Plast Reconstr Surg 1993;91(4):657–662CrossRefPubMedGoogle Scholar
  3. 3.
    Spear S, Mijidian A: Reduction mammaplasty and mas-topexy: general considerations. In: Spear SL (ed), Surgery of the Breast: Principles and Art. Philadelphia, Lippincott-Raven 1998, p 673Google Scholar
  4. 4.
    Rohrich RJ, Beran SJ, Restifo RJ, Copit SE: Aesthetic management of the breast following explantation: evaluation and mastopexy options. Plast Reconstr Surg 1998;101(3):827–837CrossRefPubMedGoogle Scholar
  5. 5.
    Elliott FL: Circumareolar mastopexy with augmentation. Clin Plast Surg 2002;29(3):337–347CrossRefPubMedGoogle Scholar
  6. 6.
    Bartels RJ, Strickland DM, Douglas WM: A new mas-topexy operation for mild or moderate ptosis. Plast Reconstr Surg 1976;57(6):687–691CrossRefPubMedGoogle Scholar
  7. 7.
    Spear SL, Kassan M, Little JW: Guidelines in concentric mastopexy. Plast Reconstr Surg 1990;85(6):961–966CrossRefPubMedGoogle Scholar
  8. 8.
    Puckett CL, Meyer VH, Reinisch JF: Crescent mastopexy and augmentation. Plast Reconstr Surg 1985;75(4):533–543CrossRefPubMedGoogle Scholar
  9. 9.
    Erol OO, Spira M: A mastopexy technique for mildto moderate ptosis. Plast Reconstr Surg 1980;65(5):603–609CrossRefPubMedGoogle Scholar
  10. 10.
    Fayman MS, Potgieter E, Becker PJ: Outcome study: peri-areolar mammaplasty patients' perspective. Plast Reconstr Surg 2003;111(2):676–684CrossRefPubMedGoogle Scholar
  11. 11.
    GrafR, Biggs TM: In search of better shape in mastopexy and reduction-mammaplasty. Plast Reconstr Surg 2002;110(1):309–317CrossRefPubMedGoogle Scholar
  12. 12.
    Wise RJ: A preliminary report on a method of planning the mammaplasty. Plast Reconstr Surg 1956;17(5):367–375CrossRefGoogle Scholar
  13. 13.
    Andrews JM, Yshizuki MM, Ramos RR: An areolar approach to reduction mammaplasty. Br J Plast Surg 1975;28(3):166–170CrossRefPubMedGoogle Scholar
  14. 14.
    Gruber R P, Jones HW: The donut mastopexy: indications and complications. Plast Reconstr Surg 1980;65(1):34–38CrossRefPubMedGoogle Scholar
  15. 15.
    Hinderer UT: Circumareolar dermo-glandular plication: a new concept for correction of breast ptosis. Aesthetic Plast Surg 2001;25(6):404–420CrossRefPubMedGoogle Scholar
  16. 16.
    Benelli L: Periareolar mammaplasty — round block technique. Rev Soc Bras Cir Plast 1990;5:44Google Scholar
  17. 17.
    Benelli L: Periareolar Benelli mastopexy and reduction: the round block. In: Spear SL (ed), Surgery of the Breast: Principles and Art. Philadelphia, Lippincott-Raven 1998Google Scholar
  18. 18.
    Goes JCS: Periareolar mammaplasty: double skin technique with application of polyglactin or mixed mesh. Plast Reconstr Surg 1996;97(5):959–968PubMedGoogle Scholar
  19. 19.
    Goes JCS: Periareolar mammaplasty: double skin technique with application of mesh support. Clin Plast Surg 2002;29(3):349–364CrossRefGoogle Scholar
  20. 20.
    Qiao Q, Sun J, Liu C, Liu Z, Zhao R: Reduction mamma-plasty and correction of ptosis: dermal bra technique. Plast Reconstr Surg 2003;111(3):1122–1130CrossRefPubMedGoogle Scholar
  21. 21.
    Gulyas, G. Mammaplasty with a periareolar dermal cloak for glandular support. Aesthetic Plast Surg 1999;23(3):164–169CrossRefPubMedGoogle Scholar
  22. 22.
    Hammond DC: Short scar periareolar inferior pedicle reduction (SPAIR) mammaplasty. Plast Reconstr Surg 1999;103(3):890–901CrossRefPubMedGoogle Scholar
  23. 23.
    Becker H: Subareolar mastopexy: update. Aesthetic Surg J 2003;23:357CrossRefGoogle Scholar
  24. 24.
    Lassus C: A technique for breast reduction. Int Surg 1970;53(1):69–72PubMedGoogle Scholar
  25. 25.
    Lassus C: Update on vertical mammaplasty. Plast Reconstr Surg 1999;104(7):2289–2298CrossRefPubMedGoogle Scholar
  26. 26.
    Peixoto G: Reduction mammaplasty: a personal technique. Plast Reconstr Surg 1980;65(2):217–226CrossRefPubMedGoogle Scholar
  27. 27.
    Lejour M, Abboud M, Declety A, Kertesz P: Reduction des cicatrices de plastie mammaire de l'ancre courte à la verticale. Ann Chir Plast Esthet 1990;35(5):369–379PubMedGoogle Scholar
  28. 28.
    Lejour M, Abboud M: Vertical mammaplasty without infer-mammary scar and with breast liposuction. Perspect Plast Surg 1990;4:67Google Scholar
  29. 29.
    Lejour M: Vertical mammaplasty: update and appraisal of late results. Plast Reconstr Surg 1999;104(3):771–781CrossRefPubMedGoogle Scholar
  30. 30.
    Chiari A Jr: The L short-scar mammaplasty: a new approach. Plast Reconstr Surg 1992;90(2):233–246Google Scholar
  31. 31.
    Marchac D, de Olarte G: Reduction mammaplasty and correction of ptosis with a short inframammary scar. Plast Reconstr Surg 1982;69(1):45–55CrossRefPubMedGoogle Scholar
  32. 32.
    Fayman MS: Short scar mastopexy with flap transposition. Aesthetic Plast Sur 1998;22(2):135–141CrossRefGoogle Scholar
  33. 33.
    Hall-Findlay E: Pedicles in vertical reduction and mas-topexy. Clin Plast Surg 2002;29(3):379–391CrossRefPubMedGoogle Scholar
  34. 34.
    Hall-Findlay EJ: A simplified vertical reduction mamma-plasty: shortening the learning curve. Plast Reconstr Surg 1999;104(3):748–759CrossRefPubMedGoogle Scholar
  35. 35.
    Caldeira AM, Lucas A, Grigalek G: Mastoplasty: the triple-flap interposition technique. Aesthetic Plast Surg 1999; 23(1):51–60CrossRefPubMedGoogle Scholar
  36. 36.
    Rohrich RJ, Cosman AA, Brown SA, Reisch J: Mastopexy preference: a survey of board-certified plastic surgeons. Plast Reconstr Surg 2006;118(7):1631–1638CrossRefPubMedGoogle Scholar
  37. 37.
    Gryskiewicz JM, Hatfield AS: Zigzag wavy-line peria-reolar incision. Plast Reconstr Surg 2002;110(7):1778–1783CrossRefPubMedGoogle Scholar
  38. 38.
    Kwei S, Borud LJ, Lee BT: Mastopexy with autologous augmentation after massive weight loss: the intercostal artery perforator (ICAP) flap. Ann Plast Surg 2006;57(4):361–365CrossRefPubMedGoogle Scholar
  39. 39.
    Voigt M, Andree C: Breast shaping by an isolated tissue flap. Aesthetic Plast Surg 2006;30(5):527–534CrossRefPubMedGoogle Scholar
  40. 40.
    Hurwitz DJ, Agha-Mohammadi S: Postbariatric surgery breast reshaping: the spiral flap. Ann Plast Surg 2006;56(5):481–486; discussion 486CrossRefPubMedGoogle Scholar
  41. 41.
    Ritz M, Silfen R, Southwick G: Fascial suspension mas-topexy. Plast Reconstr Surg 2006;117(1):86–94CrossRefPubMedGoogle Scholar
  42. 42.
    Flowers RS, Smith EM Jr: “Flip-flap” mastopexy. Aesthetic Plast Surg 1998;22(6):425–429CrossRefPubMedGoogle Scholar
  43. 43.
    Weiss PR, Ship AG: Restoration of breast contour with autologous tissue after removal of implants. Ann Plast Surg 1995;34(3):236–241CrossRefPubMedGoogle Scholar
  44. 44.
    Svedman P: Correction of breast ptosis utilizing a “fold over” de-epithelialized lower thoracic fasciocutaneous flap. Aesthetic Plast Surg 1991;15(1):43–47CrossRefPubMedGoogle Scholar
  45. 45.
    Ship AG, Weiss PR, Engler AM: Dual-pedicle dermo-parenchymal mastopexy. Plast Reconstr Surg 1989;83(2):281–290CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • Moshe S. Fayman
    • 1
  1. 1.Department of Surgery Division on Plastic SurgeryJohannesburgSouth Africa

Personalised recommendations