Enhancing Augmentation Mastopexy with Breast Implant by Extended Superior Pedicle Flap

Al Mahmoudy, Niveen Fathy; Saad, Hany; Osama, Mohamed

doi:10.21608/ejprs.2024.385094

Enhancing Augmentation Mastopexy with Breast Implant by Extended Superior Pedicle Flap

Document Type : Original Article

Authors

The Department of Plastic, Burn, Reconstructive and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University

10.21608/ejprs.2024.385094

Abstract

Introduction: Augmentation mastopexy is a challenging
operation which involves a fine balance between augmentation;
expanding the breast volume and mastopexy; reducing
the skin envelope. In implant augmentation mastopexy, many
authors proposed the use of designed dermoglandular flaps,
incorporating tissues from the inferior margin of the breast, it
clarifies the idea of using other designed dermoglandular flaps
in implant augmentation mastopexy as a tool to augment the
coverage of the implant.
Objective: Is to enhance the coverage of implant in augmentation
mastopexy using dermoglandular extension of superior
pedicle flap.
Patients and Methods: This prospective clinical study was
performed in Ain Shams University Hospitals from December
2020 – June 2023, with an average follow-up time of 9 months.
16 women complaining of ptotic hypoplastic breasts, underwent
augmentation mastopexy.
Results: All patients underwent augmentation mastopexy
with superior based pedicles with extended dermoglandular
flap, the breast implants used were smooth rounded implants.
The patients had no NAC complications or hematoma. And
there were no complications related to the implant either extrusion
or infection. However minor complications have occurred
as one case with disrupted sutures, two cases with seroma and
one case of hypertrophic scarring and they were managed conservatively.
Conclusion: Utilizing the extended dermoglandular flap to
cover the implant in superiorly based augmentation mastopexy
offers a reliable method with minor complications and high
satisfaction scores.

Keywords

Main Subjects

Aesthetics

References

Kim P., Kim K.K. and Casas L.A.: Superior Pedicle Autoaugmentation
Mastopexy: A Review of 34 Consecutive
Patient, Aesthetic Surgery Journal, 30 (2): 201–210, 2010.
2- Khavanin N., Jordan S.W., Rambachan A. and Kim J.Y.:
A Systematic Review of Single-Stage Augmentation-Mastopexy,
Plast. Reconstr. Surg., 134 (5): 922-931, 2014.
3- Biggs T.M., Graf R. and Taneja A.: Maintaining shape in
mastopexy, Aesthet. Surg. J., 23 (5): 391–392, (2003)
4- Lazaro Cardenas-Camarena and Roberto Ramırez-Macıas:
Augmentation/Mastopexy: How to Select and Perform the
Proper Technique, Aesth. Plast. Surg., 30: 21-33, 2006.
5- Roy de Vita, Giovanni Zoccali and Ernesto Maria Buccheri:
The Balcony Technique of Breast Augmentation and
Inverted-T Mastopexy With an Inferior Dermoglandular
Flap, Aesthetic Surgery Journal, 37 (10): 1114–1123,2017.
6- Eduardo Melero Forcada, Miguel Calderon Fernandez,
Jorge Vizan Aso, Israel Pena Iglesias and Augmentation
Mastopexy: Maximal Reduction and Stable Implant Coverage
Using Four Flaps, Aesth. Plast. Surg., 38: 711–717,
2014.
7- Scott L. Spear, Christopher V. Pelletiere and Nathan
Menon: One-Stage Augmentation Combined with Mastopexy:
Aesthetic Results and Patient Satisfaction. Aesth.
Plast. Surg., 28: 259–267, 2004.
8- Lejour M.: Vertical mammaplasty: Early complications after
250 personal consecutive cases. Plast. Reconstr. Surg.,
104 (3): 764-770, 1999.
9- Persoff M.M.: Vertical mastopexy with expansion augmentation.
Aesth. Plast. Surg., 27: 13-19, 2003.
10- Swanson E.: A retrospective photometric study of 82 published
reports of mastopexy and breast reduction. Plast.
Reconstr. Surg., 128: 1282–1301, 2011.
11- Scott L. Spear, Mervin Low and Ivica Ducic: Revision
Augmentation Mastopexy: Indications, Operations, and
Outcomes, Ann. Plast. Surg.; 51: 540–546, 2003.
12- Mestak J., Sukop A. and Mestak O.: Use of deepithelialized
flap in mammoplasties: Simple method with excellent
results. Aesthetic Plast. Surg., 35: 1106–1111, 2011.
13- Ladizinsky D.A., Sandholm P.H., Jewett S.T., Shahzad F.
and Andrews K.: Breast reconstruction with the Bostwick
autoderm technique. Plast. Reconstr. Surg., 132 (2): 261–
270, 2013.
14- Albert Losken and Christopher D.: Funderburk, Claire
Duggal. The Extended Superomedial Pedicle: Advancing
Mammaplasty Techniques. Modern Plastic Surgery, 3: 20-
27, 2013.
15- Spear S.L., Sinkin J.C. and Al-Attar A.: Porcine acellular
dermal matrix (Strattice) in primary and revision cosmetic
breast surgery. Plast. Reconstr. Surg., 131 (5): 1140–1148,
2013.
16. Spear S.L., Boehmler J.H. IV and Clemens M.W.: Augmentation/
mastopexy: A 3-year review of a single surgeon’s
practice. Plast. Reconstr. Surg., 118 (Suppl):
136S–147S, 2006.
17- Gonzalez R.: The PAM method periareolar augmentation
mastopexy: A personal approach to treat hypoplastic
breast with moderate ptosis. Aesthet. Surg. J., 32: 175–
185, 2012.
18- Stevens W.G., Freeman M.E., Stoker D.A., Quardt S.M.,
Cohen R. and Hirsch E.M.: One-stage mastopexy with
breast augmentation: A review of 321 patients. Plast. Reconstr.
Surg., 120: 1674–1679, 2007