Autoaugmentation mastopexy using the double-flap technique

Abstract

Breast drooping usually results from two concomitant factors: breast parenchymal involution, which leads to volume loss, altogether with a progressive laxity of the skin envelope which becomes inelastic and flabby (means so loose). The authors propose a double-flap technique which includes transposition of inferiorly based dermoglandular tissue underneath a superiorly based flap to achieve a central projection and upper fullness altogether with raising the inframammary crease. From May 2016 to November 2018, 25 patients underwent a double-flap autoaugmentation mammoplasty performed by the authors. Ages ranged from 25 to 45 years. All patients were nonsmokers and had body mass indexes (BMI) of less than 30. The mean follow-up period was 18 months All cases have had grade III breast ptosis with a broad-base, flappy breasts with deficient central projection. All patients aimed at having an augmented, elevated breast without insertion of a silicon implant. A total of 23 cases showed a significant improvement in breast contour and central projection, with overall satisfaction to both patient and surgeon. Two cases progressed to an implant augmentation subsequent to the mastopexy. One patient had postoperative seroma that were managed with frequent aspirations. The nipple areola complex (NAC) wounds passed smoothly in all cases without any complications regarding the vascularity or wound infection. The double-flap autoaugmentation mastopexy is a method of breast reshaping that adopts a concept of glandular rearrangement. In properly selected patients with adequate breast volume and moderate skin elasticity, with mild to moderate ptosis, who refuse a prosthetic implant insertion, this procedure safely and adequately restores the youthful conical breast appearance. Level of evidence: Level IV, therapeutic study.