Preservation of breast ligamentous structures in mastopexy: achieving aesthetic excellence with minimal complications

Abstract

Background: Breast ptosis has traditionally been addressed through mastopexy techniques, but there is an increasing focus on preserving breast anatomy to minimize complications. This includes conserving critical ligamentous and fascial structures, considering that traditional techniques may lead to loss of support and adverse outcomes. Objective: The study aims to introduce a novel mastopexy technique that prioritizes ligament preservation, with the option to include breast implants, emphasizing patient safety and exceptional aesthetic outcomes. Design: The study design included a descriptive statistical analysis of a novel mastopexy technique applied to 138 patients with a minimum 1-year follow up, performed by a single surgeon in San José, Costa Rica, from August 2020 to September 2022. Preoperative measurements, breast implant data, and postoperative outcomes were described. Results: A total of 138 patients who underwent preservation mastopexy were analyzed. The median age was 39 years (interquartile range [IQR] 33 – 45) with a 28-month median follow-up. Preoperative measurements included a median nipple-to-inframammary fold distance of 9.5 cm (IQR 8 – 11) and a base diameter of 10.5 cm (IQR 10 – 11). Major complications included one readmission for hematoma drainage (0.7%), no major flap or nipple loss, and minor issues involving dog ears (1.4%) and hypertrophic scars (1.4%) requiring revisions. No seroma or implant-related complications were reported. Discussion: This study’s innovative mastopexy technique prioritizing breast ligament preservation, with or without adjunctive implants, achieved excellent aesthetics and low complications. This approach, aligned with personalized breast surgery principles, demonstrates the significance of preserving ligamentous support and natural breast architecture. Safety concerns were effectively addressed, emphasizing the technique’s ability to reduce adverse events, substantiated by statistical evidence and earlier studies. Conclusions: This study demonstrates a low complication rate and favorable aesthetic outcomes with a novel mastopexy technique that prioritizes breast ligament preservation. It utilizes breast implants when needed as an addendum to preexisting breast tissue, basing its selection on objective measurements and overall body proportions.