Improve Breast Shape Research Articles

Immediate Latissimus Dorsi Flap Reconstruction: Assessing Aesthetic Outcomes Following Mastectomy in Breast Cancer Patients.

Breast Cancer has now become the leading cause of cancer-related deaths among women. In a traditional radical mastectomy, there can be complications that may affect the physiological characteristics of the breast and subsequently cause profound psychological stress to the patients. Hence, latissimus dorsi (LD) flap reconstruction provides an aesthetic approach in patients undergoing mastectomy. The goal is to maximize the flap's soft tissue coverage while minimizing the magnitude of donor site defect and complication. A prospective observational study was conducted in the Department of General Surgery, Safdarjung Hospital, New Delhi, India, where 30 breast cancer patients were enrolled and had undergone mastectomy with immediate LD flap reconstruction. Cosmetic assessments using BREAST-Q questionnaires were conducted postoperatively at various intervals starting from postoperative day one, week two, and week six. The subjective evaluation was done by the patient, while a blinded nurse and surgeon did the objective assessment. The majority (n=23, 76.7%) were aged 31-50 years. Initial postoperative BREAST-Q scores declined but significantly improved by week six, attributed to gradual wound healing over time, resulting in improved breast shape and contour. The objective scoring done by the blinded surgeon and nurse improved at six weeks compared to two weeks postoperatively. Almost similar outcomes were observed between preoperative and six-week postoperative scores with a significant overall p-value of <0.001. No significant statistical differences were noted between blinded surgeons and nurses for objective scoring. The rising trend of breast cancer in younger demographics emphasizes the importance of balancing cosmetic satisfaction with oncological outcomes. Immediate LD flap breast reconstruction provides a reliable means for soft tissue coverage with acceptable perioperative morbidities for patients undergoing mastectomy. Complication rates were acceptable, with donor site seroma, surgical site infection (SSI), and shoulder weakness among them. They could be prevented or treated (prolonged drain in situ, quilting sutures, and seroma aspiration) or resolved with time (SSI and shoulder function).

Vertical Scar Mastopexy With a Centrally Based Auto-Augmentation Flap.

The authors describe their technique for vertical scar mastopexy with a centrally based auto-augmentation flap. Since 2011, the authors have performed this procedure in 212 patients and found that this operative technique has allowed us to achieve reproducible aesthetic outcomes while minimizing complications. Vertical scar mastopexy with a centrally based auto-augmentation flap is an excellent procedure for patients with breast ptosis who desire improved breast shape and superior pole fullness without the use of a breast implant. The perioperative management and detailed steps of the procedure are outlined.Level of Evidence: 5

Value of Triplicated Inferior Pedicle Breast Reduction in Improving Cosmetic Outcome in Upper Outer Quadrant Breast Cancer Patients

Abstract Background: Breast is the true mirror of femininity. Breast cancer is one of the diseases that affect the psychological state of women, not only because of the complications it entails, but also because of the negative impact of treatment on women psychologically and physically. Aim of Study: The aim of this work is to assess the effect of triplicated inferior pedicle technique on improving cosmetic outcome in patients with breast cancer in upper outer quadrant. Patients and Methods: This study conducted at Ain Shams University hospitals, starting January 2020 till May 2020 with follow up 6 months.The study include 15 patients from 30- 50 year. This prospective study started with 15 Female patients with breast cancer in upper outer quadrant or upper pole lesion. During the period of the study at Ain-Shams University Hospitals. The data was collected and presented as followed in several tables and figures. Results: In our study the mean value of immediate post-operative SN-N was 21cm. After 6 months the mean value of postoperative SN-N was 21.5cm. In the current study the mean value of preoperative inframammary fold- nipple distance (IMF-N) was 17.27cm. In our study mean value of immediate postoperative IMF-N was 7.33cm, and After 6 months the mean value of postoperative IMF-N was 8cm. So, triplicated inferior pedicle is to obtain the benefits and avoid the most annoying complication and maintain the shape of breast after breast reduction without significant difference in postoperative complications. Conclusion: Breast reduction is a procedure, which has evolved tremendously over the years due to the continuous and ongoing quest to achieve the objective of reducing the breast size, improving breast shape and relocating the nipple areola complex, while minimizing scars and also preserving lactation and innervation to the nipple-areola complex.

A comparative study between round block technique and standard wide local excision in patients with breast cancer

Background The purpose of optimizing the cosmetic and oncological results of breast conservative surgery (BCS) has been addressed in recent years by the advent of the field of oncoplastic surgery, originally defined as an assortment of volume replacement techniques. Recently, the concept of oncoplastic surgery has been expanded to include a wide range of volume-displacement or volume-transfer procedures performed by breast surgeons and general surgeons to improve breast shape and breast volume during breast cancer operations. Aim The aim was to assess the round block technique regarding oncological safety, surgical outcomes, and patients’ satisfaction and to compare the results with standard wide local excision. Patients and methods This is a prospective randomized trial to test the round block technique as an oncological procedure for the early management of breast cancer near the nipple–areola complex in terms of oncological safety, surgical outcomes, and patients’ satisfaction and to compare the results with standard wide local excision. A total of 20 patients with breast cancer were subdivided into group A, which comprised 10 female patients who underwent round block technique, and group B, which comprised 10 female patients who underwent standard wide local excision. Patient and tumor criteria, including age, comorbidities, tumor size, and distance between tumor and nipple-areola complex, were considered to be nonsignificant between the two groups, so the only difference is the surgical technique. Results The round block technique and standard wide local excision (SWLE) have the same results regarding operating time, intraoperative blood loss, and postoperative complications, with radiation of breast therapy (RBT) being advantageous because of its better cosmetic outcomes and lower re-excision rates. Conclusion Despite no evidence of increased surgical complications, the round block procedure has equivalent operating parameters to SWLE. In round block, patients were found with lower re-excision rates and better cosmoses, as a scarless procedure, without nipple and areola shift, which indicates that the round block technique is superior to selected SWLE.

Mastopexy

Mastopexy and mastopexy-augmentation are commonly performed surgeries to lift ptotic breasts while improving breast shape and volume. Factors that cause breast ptosis include aging, hormonal changes, and weight loss. Common surgical approaches for mastopexy utilize the periareolar, vertical, and wise techniques. All of these techniques incorporate parenchymal rearrangement in addition to skin envelope resection in order to achieve the patient’s aesthetic goals. A plastic surgeon should carefully select the appropriate mastopexy technique based on a patient’s preoperative grade of ptosis, breast shape/volume, and aesthetic goals. Many of these mastopexy techniques can be combined with implant augmentation, either as a single or two-stage procedure in appropriate patients with volume concerns. Revisions tend to be more common after implant-augmentations and may be necessary based on patient concerns and surgeon discretion. This review contains 5 figures, 5 tables, and 14 references Keywords: mastopexy, mastopexy-augmentation, breast lift, breast ptosis, vertical mastopexy, periareolar mastopexy, wise pattern mastopexy, breast surgery

Single Staged Mastopexy With Autologous Fat Grafting: An Alternative to Augmentation Mastopexy With Implants.

Improving the ptotic breast with mastopexy and restoring upper pole fullness with augmentation continues to be a challenging issue for plastic surgeons. Autologous fat grating (AFG) for shaping and contouring of implant augmented breasts has shown positive outcomes with few complications. The objective of this study was to evaluate our experience with combined mastopexy and fat grafting for women with existing breast ptosis who prefer not to receive prosthetic breast implants but do desire volume enhancement. A retrospective review of patients undergoing a single staged mastopexy with AFG, from 2006 to 2017, was performed. Inclusion criteria were women with breast ptosis or tuberous breasts desiring improved breast shape and volume. Patients were excluded if they were undergoing implant removal before the procedure. Clinical aesthetic outcomes were assessed by fellow plastic surgeons according to the Telemark Breast Scoring system. A total of 284 breasts, in 140 women, underwent a single staged mastopexy with AFG. The mean amount of fat grafted per breast was 299.4 mL (range, 50-710 mL). There were no surgical site infections, hematomas, or seromas. There were 3 major and 8 minor (0.06%) postoperative breast complications. A total of 13 plastic surgeons, of the 183 invited (7.1%), completed the breast outcomes survey. Regarding each category, there was significant improvement (P ≤ 0.0001) in upper pole fullness, ptosis, overall aesthetics, and symmetry postoperatively. AFG combined with mastopexy is not associated with significant postoperative complications and results in excellent breast aesthetic outcomes.

Dual-Anchor Cog Threads in Fat Grafting Breast Augmentation: A Novel Scarless Method for Defining Breast Footprint and Enhancing Shape.

Modern fat grafting breast augmentation allows successful breast enhancement. However, there is no fine control of breast footprint, shape, and inframammary fold. The purpose of this article is to report a novel scarless technique and to evaluate its beneficial effect by retrospectively reviewing case-control consecutive data from 51 patients. Fifty-one consecutive patients undergoing cosmetic breast augmentation with fat only between September of 2012 and August of 2016 were retrospectively reviewed. In the first 29 cases (56 percent), the authors did not use threads (group A, control group), whereas in the remaining 22 cases (44 percent), the authors used dual-anchor cog threads (group B, case group). Breast shape analysis was performed separately by a blinded group of plastic surgeons and by the attending surgeon using a standardized evaluation method. The BREAST-Q was used to study patient satisfaction. The Mann-Whitney U and chi-square tests were used for categorical variables, and the independent-samples t test was used for continuous variables. No significant difference in mean graft take was found (group A, 71.2 percent; group B, 71.6 percent; p < 0.05). Group B showed a significantly higher rating than group A for lower pole profile, inframammary fold, and lateral footprint definition. No major postoperative complications were experienced in either group. In group B, no thread-related complications were experienced. The dual-anchor thread suture is a novel, effective, simple, reliable, safe, and scarless method of improving breast shape in fat grafting breast augmentation. Larger series are needed to further confirm the authors' findings. Therapeutic, III.

Secondary Mastopexy After Nipple-Sparing Mastectomy and Staged Subcutaneous Expander/Implant Reconstruction.

The acceptance of nipple-sparing mastectomy for the treatment of breast cancer in selected patients has introduced ancillary procedures to improve breast shape, correct ptosis, and enhance breast symmetry. Mastopexy before or at the time of nipple-sparing mastectomy has been performed to correct ptosis, but there have been no reports on secondary Wise pattern mastopexy after completion of staged subcutaneous expander/implant reconstruction. Between 2005 and 2015, 155 patients (255 breasts) underwent staged subcutaneous implant/expander-based reconstruction after inframammary nipple-sparing mastectomy. Of the 155 patients, 10 (6.5%) patients required a secondary Wise pattern mastopexy (n = 14, 5.5%). The nipple was raised 2.5 to 6 cm (range, 3.8 cm), and the implant location was adjusted accordingly for optimal positioning with respect to the nipple-areola. The secondary mastopexy was performed to correct ptosis, improve breast symmetry and/or contour deformities of the breast, and relieve pain associated with large implants. All mastopexies healed without complications, and the goals of the revisions were achieved. There were no capsular contractures after an average of 50 months (range, 19-92 months). The patients were satisfied with the aesthetic and functional improvement. Secondary mastopexy after 2-stage subcutaneous expander/implant breast reconstruction is uncommon, but if needed, it may be safely performed to correct ptosis and improve breast shape, symmetry, and function.

Mastopexie nach massivem Gewichtsverlust – Erweiterte Ribeiro-Technik und Einsatz der lateralen Interkostalarterien-Perforatorlappenplastik (LICAP-Flap) zur Autoaugmentation

Mastopexy in massive weight loss patients is challenging. The breast mound is often unstable and deflated, with a loose inelastic skin envelope. It has become apparent that mammaplasty techniques in these cases should rely more on glandular recontouring rather than on the skin envelope for shaping. Published methods include plication, suspension and autoaugmentation. The residual local tissue (glandular breast tissue, fat tissue, dermoglandular fat flap) is utilised to its full extent in order to reshape a form-stable breast with full upper pole projection. The evolution of a technique is presented. In this study we retrospectively analysed 68 massive weight loss patients who underwent an extended Ribeiro technique with a superomedial pedicle mastopexy and suspension by an inferior dermoglandular flap. The current procedure involves incorporating the lateral intercostal artery perforator flap (LICAP flap) and medial breast pillar additionally to the inferior dermoglandular Ribeiro flap. This essentially autoaugments the upper pole by creating an "autoprosthesis", narrows the widened breast, and redefines the inframammary fold. The outcome parameters complication rate, patient satisfaction with the aesthetic result, nipple sensibility and surgical revision rate were obtained. From 01/2011 to 12/2016, we performed 136 autoaugmentation mastopexies. The average age was 41.2 years, average body mass index (BMI) was 27,1 kg/m2, average weight loss was 54.3 kg, average sternal notch-NAC distance was 32.3 cm, average operation time was 109 minutes. In 12 breasts, a free-nipple graft was necessary. The complication rate was 5.1 %, surgical revision rate was 17.6 %. 95 % of the patients were "very satisfied" or "satisfied" with the aesthetic result. Nipple sensibility was rated as "very good" or "good" by 85 % of patients. Modification of the Ribeiro technique by using the medial and lateral breast pillar (LICAP flap) allows autoaugmentation of the upper pole. Parenchymal shaping through plication and suspension of the breast mound should improve breast shape over time, with the aim of reducing the incidence of recurrent ptosis. The presented technique is a reproducible and reliable method with a low complication rate.

Postreduction Breast Augmentation.

Background:Most breast reduction patients are highly satisfied after surgery. However, there is a subset of women who seek breast augmentation years later to restore lost volume chiefly associated with weight loss and postpartum changes. Breast shape and overall aesthetics are often revised at the same time.Methods:A retrospective review was performed of 2 surgeons’ experiences with post-reduction breast augmentation. Twenty patients were identified between 2002 and 2014. An in-depth chart review was conducted to determine patient motivation and to examine the operative techniques employed. Implant variables, a reduction specimen weight to implant volume comparison (where available), and complications are reported.Results:The average age was 37.1 years and average body mass index was 21.8 kg/m2. Most patients waited over a decade to have their breasts revised. Weight loss was the motivating factor in 8 patients and pregnancy changes in 11. Nineteen patients wished to stay with the same bra size or 1 cup size larger. Although all patients elected to have an implant placed, 19 patients wished to have an improved breast shape, not specifically a larger volume. The average breast implant was 203.5 cm3 (range, 120–340 cm3). Complications from implant placement included a seroma treated by aspiration and a Baker class III capsular contracture that required surgical correction.Conclusions:A small subset of reduction mammaplasty patients seek breast augmentation many years later primarily to improve breast contour, not to restore their prereduction breast volumes. Conservative augmentation combined with revision of breast shape and areolar aesthetics yields good results with minimal complications.

Instant implantation of breast after removal of polyacrylamide hydrogel for breast augmentation

Objective To investigate the clinical indication and effect of instant reconstruction of breast after removal of polyacrylamide hydrogel injection for breast augmentation.Methods Patients had breast ultrasound,MRI check before operation,to define the distribution and level of the injections and tissue infiltration.Depending on tissue degree,capsule integrity and breast degeneration situation,three different methods were chosen,including implantation of silicone gel underneath the breast,pectoralis major or dual-plane.Results 56 patients' incision healed well.Follow-up for 6 months to 3 years showed that breast shapes were good without scars,prosthetic herniapsular,capsular contracture and other complications.Conclusions Instant reconstruction of the breast after removal of polyacrylamide hydrogel injection can improve breast shape and get satisfied effects. Key words: Polyacrylamide hydrogel; Silica gel; Breast implants; Breast augmentation surgery

Breast Augmentation for Ptosis: Effective Upward Rotation of the Nipple

Background For the correction of small ptotic breasts, augmentation mastopexy provides a better shape than other techniques, but its periareolar or vertical scar is a limiting factor. Subglandular augmentation tends to increase ptosis. Submuscular augmentation may result in a "Waterfall" deformity (double contour deformity). This report uses examples of two patients to illustrate concepts for improving breast augmentation of ptotic breasts. Methods Two patients initially underwent insertion of breast implants for ptotic breasts, using full height type of implants inserted by the type III dual plane technique. Both patients had wanted breasts that were not excessively large, but which had an improved shape and minimal scars. At nearly the same time after the initial surgery (postoperative day 3 and 7), each patient exhibited a unilateral double contour breast deformity. The initial implants were changed to shorter height implants to shift volume to the lower pole. Results Changing the implants resulted in improved breast shape by enhancing the leverage effect. The double contour deformities observed after using the taller implants were improved by changing to shorter implants. Conclusions For rotating the nipple areolar complex upward during correction of small ptotic breasts with implants, the type III dual plane technique is an effective way to produce a larger volume pocket in the lower pole of the breast. More leverage effect can be obtained by using a shorter height and greater projection type of shaped implant instead of a full height implant. Keywords: Breast, Breast implantation, Mammaplasty, Postoperative complications

Improving Breast Shape in Breast Reduction Technique

Improving Breast Shape in Breast Reduction Technique

Revision of Wise Pattern Breast Reductions With Vertical Procedures

A small percentage of patients who undergo Wise pattern mammaplasties request revisions to address recurrent macromastia or poor breast shape. Reuse of the Wise pattern method at times results in disappointing aesthetic results. Recently, in a series of 15 consecutive patients, we used vertical techniques with glandular reshaping to perform these revisions. Advantages include the ability to significantly improve breast shape and to avoid reopening of potentially problematic inframammary scars. No major complications occurred. Patients have been uniformly pleased with the significant improvement in their breast contour, width, and size. In summary, despite the use of the Wise pattern method for the original procedure, consideration should be given to use vertical techniques for revisions in that they are safe and can better address patient goals. Gratifying results can be achieved.

Inferiorly Based Parenchymal Flap Mammaplasty

Breast reduction and mastopexy are among the most frequent procedures in aesthetic breast surgery. Many approaches have been described, and various types of dermaglandular pedicles for the nipple-areola complex have been used. The authors present a technique suitable for either mastopexy or breast reduction whereby the superior or superomedial pedicle supplying the nipple-areola complex is combined with an inferior dermaglandular flap to restore the upper pole fullness, thereby improving breast shape and projection. From January of 2008 to January of 2010, 83 patients underwent inferiorly based parenchymal flap mammaplasty. Patients' ages ranged from 23 to 65 years. The mean follow-up period was 27 months. The inferior breast tissue that is usually removed in a superior/superomedial pedicle technique is spared and shaped as a small implant and stitched to the pectoralis major muscle. The superior/superomedial pedicle is used for the nipple-areola complex. All the procedures were successful. No major complications were reported. All the patients were very satisfied with the shape, size, projection, and upper pole fullness of their breast postoperatively as reported by the questionnaire. Comparative evaluation test scores of a four-member jury were significantly higher regarding breast shape (p = 0.007), projection (p = 0.0041), and upper pole fullness (p = 0.0028). The inferiorly based parenchymal flap mammaplasty is a safe, versatile, and reproducible technique. It demonstrates ease of pedicle shaping and breast remodeling in patients undergoing mastopexy and breast reduction. Therapeutic, IV.

The Evolution of Modern Breast Surgery

Breast surgery is changing from a purely resectional specialty to one in which aesthetic outcomes are becoming increasingly important. Breast conservation surgery has moved beyond ablation to techniques that maintain or improve breast shape. Knowledge and surgical skills, traditionally the remit of plastic surgeons, are crucial to the success of these new techniques and are being adopted and adapted by a new breed of oncoplastic surgeons. Professional boundaries are becoming blurred as new breast surgeons are trained both oncologically and in plastic surgery. Breast surgeons have welcomed the opportunity for interface training but plastic surgery trainees are underrepresented in applications and successful appointment to oncoplastic fellowships. This article aims to summarise the development of breast surgery as a separate specialty and how improved training, financial pressures and the attitudes of surgeons may influence the future of oncoplastic surgery.

Versatility of the Superomedial Pedicle in Managing the Massive Weight Loss Breast: The Rotation-Advancement Technique

Management of the breast following massive weight loss is challenging. Specific issues include an unstable envelope (skin laxity) and an unstable mound (decent and volume loss). The evolution of a technique is presented. A retrospective review of all massive weight loss patients who underwent superomedial pedicle mastopexy techniques was performed. The current procedure involves incorporating the lower pole of the breast and rotating it superiorly. The lateral breast flap is then advanced medially and plicated. This essentially (1) autoaugments the upper pole, (2) narrows the wide breast, (3) provides an internal sling, and (4) redefines and secures the inframammary fold. Thirty-five patients were included in the series. The average body mass index was 26.5, and the average weight loss was 121 pounds. Six patients (17 percent) had mastopexy augmentation. Wise pattern skin takeout was performed in 89 percent of patients. The revision rate for the series was 11 percent. The average follow-up was 1.7 years. The superomedial pedicle is a versatile, well-vascularized pedicle that allows for glandular plication of the lower pole and autoaugmentation of the upper pole once rotated. Parenchymal shaping through plication and suspension of the breast mound should improve breast shape over time, theoretically reducing the incidence of recurrent ptosis as breast shape relies less on the often inelastic skin envelope. It applies a familiar and reliable technique, with certain modifications, to improve results and maintain shape in the long, deflated, massive weight loss breast.

PR51 AUGMENTATION MASTOPEXY

Introduction Augmentation‐Mastopexy is a more complex procedure than either breast augmentation or mastopexy performed individually. Since the operation both increases breast size and corrects ptosis in one surgical procedure, the combination has been considered to be associated with increased risk of complications. Complications most commonly include ischemic related complications of the breast flaps or nipple areolar complex and loss of sensibility. While some authors have suggested a staged approach with augmentation followed by mastopexy, I prefer to perform augmentation mastopexy as a single technique which is an attractive alternative to two operations. The principles include initial insertion of the implant in either the subglandular or submuscular position followed by mastopexy which can be periareolar, vertical, or inverted‐T scar based on the degree of ptosis and size of the breast.Methods/Technique Augmentation is performed first so the amount of ptosis can be evaluated after the augmentation in order determine the type of mastopexy performed. The implant is placed through a periareolar incision or a vertical lower pole incision if one anticipates a vertical mastopexy scar. Implant placement is generally subglandular when sufficient soft tissue exits to provide adequate implant coverage. Care should be taken to preserve a dermal pedicle for blood supply to the nipple since subglandular dissection reduces the blood supply to the nipple areolar complex. When the breast soft tissue envelope is thin, submuscular placement is preferred for additional implant coverage. Since submuscular placement provides better coverage, there is generally less palpability and rippling. Furthermore, submuscular dissection preserves better blood supply exits to the NAC. A disadvantage of submuscular placement is increased risk of a high riding implant. The mastopexy should adequately elevate the breast to avoid a double bubble deformity is performed.Results Over the past 12 years, 98 augmentation mastopexies were performed. The average pre‐operative bra size was B‐cup and the average degree of ptosis was Grade II. The mean patient age was 55. Smooth round gel implants were used for 90% of the patients. 80% were placed submuscular and 20% were placed subglandular. A Periareolar mastopexy was performed in 25% of patients and an inverted T mastopexy was performed 75% patients. Periareolar augmentation mastopexy was performed commonly for the correction of tubular breast deformity.Generally, most patients were satisfied with their procedure as only 5% underwent revision for aesthetic indications. 2% patients suffered acute complications including hematoma and loss of nipple sensation. 9% suffered subacute and chronic complications including delayed wound healing, loss or partial loss of the NAC, and loss of nipple sensation. 5% patients required revisions surgery to correct the sequelae of delayed wound healing or NAC tissue loss.Conclusions Augmentation‐mastopexy is one of the most complex and technically demanding procedures performed in aesthetic breast surgery. Nonetheless, there is a role for the procedure due to its ability to reduce the number of procedures and provide improved breast shape. The key to success is to be aware of the most common complications and to proceed in a stepwise in order to minimize the risk of complications and maximize patient satisfaction.

Use of myofascial flaps in aesthetic breast surgery

Background The long-term stability of the breast shape, once it is achieved, should be included among the principal concerns of aesthetic mammaplasty. This goal presents a particular challenge to the surgeon treating a patient who is concerned with breast lift but also wants to preserve or even increase cup size. Objective This report details the use of a lower myofascial supportive flap (MFF) to prevent secondary breast ptosis in various clinical situations. Methods The conceptual approach was to use the MFF to reconstruct or make up for deficiencies of the superficial fascial system collagen network, which in this surgeon's view plays a key role in determining breast position and shape. The MFF flap was raised in the region of the pectoralis major and adjacent muscles based at the inframammary fold (IMF) level and sutured near the lower areola border, with the goal of recreating the IMF, stabilizing the nipple-fold distance, and providing long-term support to counteract the effects of gravity through the creation of a “balcony” flap within which the lower breast pole rests. The procedure was performed in various clinical situations, including primary mastopexy, secondary mastopexy to correct for “bottoming out” after previous surgery, mastopexy with augmentation, implant exchange plus mastopexy, and simple primary augmentation. Results The use of the MFF provided an aesthetic breast shape while maintaining upper-pole fullness. Morbidity was highest among patients who underwent primary or secondary mastopexy and lowest among those who underwent simple primary augmentation. However, in the latter group, morbidity was notably higher than in patients who underwent simple primary augmentation without the use of the MFF. Conclusions The MFF technique can provide better long-standing breast support than other procedures aimed at preventing or minimizing secondary breast ptosis. It is indicated most clearly for patients who are unwilling to give up breast volume for improved breast shape and who are unhappy with the results of previous standard mastopexy or augmentation. It is less useful in patients undergoing primary breast lift. Limitations include increased duration of surgery and increased trauma.

Improving breast shape and symmetry in reduction mammaplasty

Improving breast shape and symmetry in reduction mammaplasty