A Modified Superior Pedicle Technique for One-Stage Prosthetic Augmentation-Mastopexy in Post-Bariatric Surgery Patients

Aboul Fotouh, Sherine M

doi:10.21608/ejprs.2019.65175

A Modified Superior Pedicle Technique for One-Stage Prosthetic Augmentation-Mastopexy in Post-Bariatric Surgery Patients

Document Type : Original Article

Author

Sherine M Aboul Fotouh

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

10.21608/ejprs.2019.65175

Abstract

Background: Augmentation mastopexy in post-bariatric
surgery patients is a combined challenge that may not be
successfully addressed with traditional procedures. One stage
augmentation mastopexy techniques poses a relatively high
rate of complications and revisions. Pathological changes in
post-bariatric surgery breasts make them more complicated.
This necessitates modification of our techniques to overcome
these problems and achieve long lasting esthetic results.
Patients and Methods: Thirty five post-bariatric patients
who underwent augmentation mastopexy using a modified
superior pedicle technique and subpectoral implant placement
were included in a retrospective study. The data collected
involved: Pre-operative patients' age, body mass index (BMI),
amount of weight reduction, grade of ptosis, standard preand
post-operative photographs, patients' satisfaction, complications
and rate of revisions.
Results: This technique was successfully applied with
good to excellent results, rated by 94% of the patients after
an average follow up period of 14.3 months, 10% complication
rate and 7.1% reoperation rate.
Conclusion: The described technique provides long
lasting aesthetic results for correction of post-bariatric breast
deformity.

Main Subjects

Aesthetics

References

1- Albert L. and Daniel J.H.: Versitility of the superomedial
pedicle in managing the massive weight loss breast: The
rotation-advancement technique. Plast. Reconstr. Surg.,
120: 1060-1068, 2007.
2- Spear S.: Augmentation/mastopexy (Surgeon beware).
Plast. Reconstr. Surg., 112: 905, 2003.
3- Puckett C.L., Meyer V.H. and Reinisch J.F.: Crescent
mastopexy and augmentation. Plast. Reconstr. Surg., 75:
533, 1985.
4- Stevens W.G., Freeman M.E., Stoker D.A., et al.: Onestage
mastopexy with breast augmentation: A review of
321 patients. Plast. Reconstr. Surg., 120 (6): 1674-1679,
2007.
5- Khavanin N.B.S., Jordan S.W., Rambachan A.B.A. and
Kim J.Y.S.: A systematic review of single-stage augmentation-
mastopexy. Plast. Reconstr. Surg., 134 (5): 822-
931, 2014.
6- Regnault P.: Breast ptosis: Defintion and treatment. Clin.
Plast. Surgery, 3: 193, 1976.
7- Lejour M.: Vertical mammaplasty with liposuction of the
breast. Plast. Reconstr. Surg., 94 (1): 100-114, 1994.
8- Wong M.S.: Post-bariatric body contouring surgery after
weight loss. Ann. Plast. Surg., 77: 553-559, 2016.
9- de Zwaan M., Georgiadou E., Stroh C.E., et al.: Body
image and quality of life in patients with and without
body contouring surgery following bariatric surgery: A
comparison between pre- and post-surgery group. Front
Pschol., 5: 1310, 2014.
10- Colwell A.S., Driscoll D. and Breuing K.N.: Mastopexy
techniques after massive weight loss: An algorithmic
approach and review of the literature. Annals of Plastic
Surgery, 63 (1): 28-33, 2009.
11- Patel N.B. and Wong M.S.: Extended fasciocutaneous
flaps fo autologous augmentation-mastopexy with upper
body lift after massive weight loss. Ann. Past. Surg., 74:
541-545, 2015.
12- Rubin J.P.: Mastopexy in the massive weight loss patient:
Dermal suspension and total parenchymal reshaping.
Aesthetic Plast. Surg., 26: 14-22, 2006.
13- Spear S.L., Boehmler J.H. and Clemens M.W.: Augmentation/
mastopexy: A 3-year review of a single surgeons
practice. Plast. Reconstr. Surg., 118 (7S): 136S-147S,
2006.
14- Hurwitz D.J. and Agha-Mohammadi S.: Post bariatric
surgery breast reshaping: The spiral flap. Ann. Plast.
Surg., 56: 481-486, 2006.
15- Cannon C.L. III and Linsey J.T.: Conservative augmentation
and periareolar mastopexy reduces complication and
treats a variety of breast types. A 5-year retrospective
review of 100 consecutive patients. Ann. Plast. Surgery,
64: 516-521, 2010.
16- Calobrace M.B., Herdt D.R. and Cothron K.J.: Simultaneous
augmentation/mastopexy: A retrospective 5-year
review of 332 consecutive cases. Plast. Reconstr. Surg.
131-145, 2013.
17- Swanson E.: All seasons vertical augmentation mastopexy:
A simple algorithm, clinical experience, and patientreported
outcomes. Plast. Reconstr. Surg. Global Open.
4 (12): P e1170, 2016.