Abstract
Background: Numerous techniques have been proposed as “gold standard” for mastopexy, as for reduction mammaplasty. The quality of the breast parenchyma should be a primary factor in selecting the most appropriate technique for an individual case. Objective: The article describes a simple technique that can be used either for mastopexy or for reduction mammaplasty, giving optimal breast shape and position. It is appropriate for patients having some degree of ptosis, and especially for those in whom the glandular component of the breast predominates. Methods: The technique entails elevating the entire dome of the breast, rolling it under, and then stitching the two halves of the breast parenchyma together (lateral and medial dermoglandular flaps), while the upper pedicle (a third dermoglandular flap) bearing the nipple areolar complex (NAC) severed from the two inferior flaps is attached as a cap. The result is a new and attractive shape of the underlying supporting “barrel”. The technique can be performed with the T scar or the vertical scar approach. Results: The procedure was applied for various indications on 45 patients aged 20 - 62 years. Good results were only achieved in 36 women with predominant glandular component. Nine patients with fatty breasts achieved unsatisfactory results (6 with T scar, 3 with vertical scar) and very poor breast projection. Conclusions: The best-suited candidates for the proposed technique for mastopexy or reduction mammaplasty are women in whom the glandular component of the breast predominates. This simple technique, applicable with either inverted T scar or vertical scar approaches, carries very low morbidity, affording an attractive profile, long-lasting results, and conserving the patient’s ability to breast feed.
Highlights
A mammaplasty that is not of the additive type almost always entails some reduction of the breast volume; such a reduction, of almost one size, occurs in the pure mastopexy [1]
Mastopexy (Figure 2(a), Figure 2(c)) and reduction mammaplasty (Figure 2(b), Figure 2(d)) have two surgical stages in common: sculpting the nipple areolar complex (NAC) pedicle, and the “rolling stage”, during which the bilateral dermoglandular flaps of the base of the breast are rolled upon themselves (Figure 3)
Blade deepithelialization is recommended for the NAC pedicle, and scissors de-epithelialization for the remainder of the area
Summary
A mammaplasty that is not of the additive type almost always entails some reduction of the breast volume; such a reduction, of almost one size, occurs in the pure mastopexy [1]. Objective: The article describes a simple technique that can be used either for mastopexy or for reduction mammaplasty, giving optimal breast shape and position It is appropriate for patients having some degree of ptosis, and especially for those in whom the glandular component of the breast predominates. Conclusions: The best-suited candidates for the proposed technique for mastopexy or reduction mammaplasty are women in whom the glandular component of the breast predominates. This simple technique, applicable with either inverted T scar or vertical scar approaches, carries very low morbidity, affording an attractive profile, long-lasting results, and conserving the patient’s ability to breast feed
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