Artificial Intelligence, Genuine Outcome: Analysis of 72 Consecutive Cases of Subfascial Augmentation Mastopexy With Smooth Round Implants Supported by P4HB Scaffold.

Abstract

Ptosis recurrence often leads to unsatisfactory results after mastopexy, even more so when additional stress is provided by implants on compromised native tissue. Poly-4-Hydroxybutyrate(P4HB) scaffold(GalaFLEX) with its favorable safety profile and proven long-term mechanical strength represents a preferred option for soft-tissue support. Primary endpoint was to assess lower pole stretch from early post operative time up to 3 years. Out of 151 patients operated by the first author from March 2020 to December 2023, a total of 72 with 12-month-mininum follow-up undergoing primary(46) or secondary(26) augmentation mastopexy with subfascial round smooth implants and P4HB scaffold support were included in the study. A 3-D artificial-intelligence (AI) software was used for all measurements. Further analysis included evaluation of ptosis recurrence and all complications. No recurrent ptosis, bottoming out, implant displacement or capsular contracture were reported during follow up (mean 24.8 months). Lower pole arch's elongation was 8.04% and 9.44% at 1 and 3 years respectively, comparing favorably with previous reports. Statistically significant correlation (p < 0.05) between implant size and lower pole stretch was noted, this being greater for larger implants (>400 cc; p = 0.0011) and primary cases (p = 0.1376). Progressive volume redistribution from upper to lower pole was observed in the first year with substantial stability thereafter. This is the largest published series reporting long-term results (up to 45 months) in mastopexy augmentation with GalaFLEX, suggesting its supportive role in lower pole stability even in the setting of concurrent breast augmentation with smooth implants in a subfascial plane.