Mastopexy Techniques Research Articles

Explantation with Lateral Pedicle Mastopexy.

While breast explantation combined with mastopexy is an increasingly common procedure, it does present certain technical difficulties. We present a technique of explantation mastopexy with the use of an extended lateral pedicle for auto-augmentation. A consecutive series of 40 cases was retrospectively reviewed, with patient reported outcome questionnaire and photography at 3 and 12 months. The mean age was 57 years (range 40 - 70 years), and mean duration of implantation was 20.4 years (range 7 - 42 years). 12 women had undergone previous mastopexy (30%). Minor wound complications requiring simple dressings were seen in 7 cases (17.5%). Major infected wound problems occurred in 1 case, who was a smoker and had other co-morbidities. All except 1 case reported being satisfied or very satisfied with the outcome, with a mean patient reported satisfaction score of 4.9/5. When the photographs were independently assessed by a cosmetic practitioner, all cases were rated as average, good or very good, with a mean score of 4.1/5. The procedure is associated with low risk of post-operative complications, good cosmetic outcomes, and a high degree of patient satisfaction. We feel this technique provides a logical, reproducible method for combined explantation and mastopexy.

The Omega Mastopexy Technique for the Correction of Breast Ptosis after Breast Implant Explantation.

The past few years have seen a 50% increase in breast implant explantations. Patients with ptotic breasts may desire mastopexy, although conventional techniques are often invasive. We describe our experience with the omega mastopexy technique after breast implant explantation and capsulectomy. In the past 2 years, 10 patients with breast Regnault classification ptosis grade I-III underwent the omega mastopexy technique following breast implant explantation and capsulectomy. A detailed description of our operating technique is provided. This series includes a total of 10 patients. The median age was 48.5 (IQR 42.8-52.5), median body mass index 26 (23.8-28.3) and median implant volume 355 (IQR 325-375). Excellent and stable aesthetic results were achieved without recurring ptosis. One patient, an active smoker, underwent reexcision after 1 year due to hypertrophic scars. No complications have been reported until this date at 2 years follow-up. The omega mastopexy technique offers an excellent alternative to classic lifting techniques for ptotic breasts after breast implant explantation. Patients with increased risk of wound healing impairment are especially likely to benefit.

Tailor-Made Mastopexy Plus Implant, A Safe Journey Toward Breast Reshaping and Augmentation.

Augmentation/mastopexy represents one of the most complex procedures in the setting of cosmetic surgery, and there is still an ongoing debate about the most suitable approach to undertake to avoid major complications and deliver the desired result. The present study aims to offer a further contribute to the topic by presenting our personal experience with an implant-guided tailor-made mastopexy technique to manage moderate breast ptosis and hypotrophy. A retrospective analysis of our database was carried out, and a total of 194 women who underwent a tailor-made resection pattern mastopexy plus implant from November 2016 to December 2021 were enrolled. All patients included in the study presented breast hypoplasia and ptosis classified as Regnault grade II. At the first-year follow-up visit, patients received an anonymous written questionnaire that addressed their self-perception of cosmetic results and overall satisfaction. The technique presented in the study showed a favorable safety profile with a total complication rate accounting for an 8.2% and an overall reoperation rate as low as 4.6%. Major concerns including wound dehiscence, implant exposure, and nipple necrosis are not reported. Patients' self-reported outcomes revealed high satisfaction rates and stable results in the long-term follow-up. The described approach ensures proper reshaping together with the desired increased breast volume minimizing the chance of implant exposure due to wound dehiscence or any sort of tissue necrosis from devascularized skin edges. The surgical procedure described herein is safe and reliable. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Round Autoprosthesis: Use of Adipodermaglandular Flap in T Scar Mastopexy.

This study focuses on the use of round or anatomically shaped breast autoprosthesis with different volumes prepared from the central and lower poles of the breast. The technical details and surgical outcomes for patients with varying degrees of breast ptosis are discussed. This study involved 42 patients who underwent the Wise-pattern superior pedicle mastopexy procedure using the adipodermaglandular island flap technique. The research spanned from December 2017 to August 2022. The study participants had not previously undergone breast surgery, did not desire breast implants, and exhibited grade 2 and 3 breast ptosis according to the Regnault Classification. Age and preoperative breast measurements of the patients were recorded for subsequent analysis. Measurements, such as the distance from the nipple-areolar complex to the inframammary fold and the distance from the suprasternal notch to the nipple-areolar complex, were taken both before the surgery and one year after. A systematic process was followed to identify acute and subacute complications during the postoperative follow-up period. This study involved 42 patients with a mean age of 33.9 years (range: 23-49 years). These procedures were conducted between December 2017 and August 2022. The average SN-N distance before surgery measured 26.7cm (range: 24-33cm). One year after surgery, the average SN-N distance was 23.1cm (range: 21.3-24.8cm). The follow-up duration for the examined cases ranged from 12 to 18 months on average. Among the observed cases, delayed wound healing was noted in one instance, venous insufficiency of the nipple in another, and fat necrosis in a third case. The overall complication rate in the group was determined to be 7.1%. In our study, the detachment of dermal connections at the level of the inframammary fold (IMF) and the smooth advancement of the flap in the form of an "island flap" made a contribution to upper pole fullness. Furthermore, we hypothesize that the fusion of the medial and lateral ends of the flap will enhance tissue integration during the healing process, promoting compatibility between the autoprosthesis tissue and breast tissue. Regarding the rates of complications described, classic mastopexy techniques have exhibited similar rates in our findings. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Creating a New Inframammary Fold, Raising the Breast Footprint and Elongating the Torso with Multiplane Concept.

Augmentation mastopexy focus on restoring the youthful appearance of the female breast. Despite those benefits, there is large scarring to be considered, and the reduction of this side effect is the main goal to enhance the aesthetic result. This article aims to describe a variation of the L-shaped mastopexy technique without complex marking and performed in planes, which brings long-term results for patients undergoing this approach. This is a retrospective, observational study, based on a series of cases conducted by the author. The preoperative appointment and the surgical technique are described, and divided into steps according to their components: cutaneous, glandular tissue, and muscular. Between January 2016 and July 2021, 632 women underwent surgery. The mean age was 38 years (18-71 years). The mean volume of implants was 285cc (175-550cc). All the implants used were round with a nanotextured surface. The mean tissue resected from each breast was 117g (5-550g). Follow-ups ranged from 12 to 84 months, and photographic documentation was performed from 30 days after surgery. Complications totaled 19.30% and were divided into minor - treated with expectant treatment, non-invasive or with the possibility of correction with local anesthesia, corresponding to 10.44%; and major - in which it was necessary to return to the operating room, corresponding to 8.86%. Multiplane L-Scar Mastopexy is a versatile and safe technique with predictable results, which allows the systematic treatment of the most diverse breast types, with complications similar to other already described and solidified techniques.

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

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.

A Safe and Simple Method of Augmentation Mastopexy

Introduction: Combining breast augmentation with mastopexy has historically been considered challenging, with concerns about complications and suboptimal aesthetic outcomes. However, recent data suggest that the combined procedure can be performed safely and effectively. Materials and Method: This article presents a technique for augmentation mastopexy that aims to minimize complications and is safe to perform. The technique focuses on preserving a robust blood supply, minimizing lower breast contour bottoming out, maintaining upper pole fullness, reducing the risk of recurrent ptosis, minimizing scar burden, and avoiding periareolar scar widening. Precise preoperative and intraoperative markings are crucial for achieving long-lasting results. The use of tailor tacking and marking the vertical excess with the patient in an upright position provides a reliable method for determining the amount of soft tissue resection required. Results: The results are shown in the postoperative photographs at 10 days, 1 month, and 3 months, respectively. These are compared with the preoperative photographs of the patient’s features. Discussion: The technique incorporates the use of an implant placed in the dual-plane subpectoral pocket to address upper pole flatness and provide structural support in the lower pole. The article emphasizes the importance of preserving Cooper’s ligaments during skin resection to maintain the supportive role of the skin. Vertical wedge resection of the lower pole is employed to reconstruct the breast cone and create a strong vertical fibrous band, which contributes to the long-term shape and support of the breast. The article also discusses techniques to mitigate nipple-areolar complex widening and emphasizes the importance of patient selection based on specific criteria. Conclusion: Overall, the authors present a safe and simple technique for augmentation mastopexy that aims to achieve long-lasting results with minimal complications. The authors advocate for careful patient selection and adherence to their methodology, which incorporates principles of preserving blood supply, maintaining breast contours, and minimizing scar burden.

Kite Mastopexy: Small Scar and Tissue-conserving Technique.

Breasts are considered one of the most physically and sexually appealing features of the female body. Reduction/augmentation techniques have greatly evolved in the last decades.We are reporting our experience with an innovative technique for mastopexy that recovers the aesthetics of the breast and avoids over-resection of its lower pole. Inclusion criteria were women who underwent kite mastopexy with or without implants between January 2018 and May 2022 in a single center (Bogota, Colombia). Exclusion criteria were patients with American Society of Anesthesiology score more than II, with any uncontrolled chronic illness and/or medical history of diabetic mellitus, metabolic syndrome, body mass index more than 32 kg per m2, and active smokers. We found 133 consecutive female patients. Age range was 18 and 67 years (median 39). Breast implants were used for the purpose of kite mastopexy in 52% cases. Patients were divided into two groups: implants (group 1) versus no implants (group 2). Procedure 1 involved mastopexy without implants; procedure 2 included current implant users who underwent either implant removal or in whom implants were not used for the sake of mastopexy. Procedures 3 and 4 included patients who underwent either new implant placement or implant exchange, respectively. Average time of surgery was 1.5 hours. Minor complications were mostly related to wound dehiscence. No major complications were reported. Kite mastopexy restores the breast aesthetics by following specific markings, a new plication of breast pillars, and a reduced scar. Our technique demonstrates a very low rate of complications while entailing natural and appealing results.

Safety and Efficacy of a Central Pedicle Technique for Mastopexy and Mastopexy with Implant Augmentation.

The central pedicle technique (CPT) is rarely used to perform mastopexy or mastopexy with implant augmentation despite having robust perfusion and allowing for great exposure, resulting in reproducible results. This study was conducted to review one surgeon's experience using the CPT for both mastopexy and mastopexy with implant augmentation. A retrospective review of consecutive patients who had a mastopexy or mastopexy with augmentation using a standardized CPT from 2017 through 2021 was performed. A total of 201 patients were identified for inclusion: 120 had a bilateral central pedicle mastopexy, 75 had bilateral central pedicle mastopexy and implants, and 6 had unilateral central pedicle mastopexy with implants because of asymmetry. Mean follow-up was 11.2 months. The average age was 45.4 years, body mass index 25.1 kg/m², and implant size 275 cc. The overall complication rate was 9.5%: 9.2% for CPT mastopexy and 9.9% for CPT mastopexy with implants. No revisional surgery was requested. None of the patients experienced nipple or skin necrosis. This study demonstrates that CPT mastopexy with or without an implant can be performed safely with a low complication rate. Additional benefits include standardized markings before surgery, visualization of the entire breast mound, and reliable perfusion. The technique excels in correcting asymmetry. CPT mastopexy with or without an implant is a safe and effective option for the treatment of breast ptosis. Therapeutic, IV.

Breast tissue density as a predictor of complications in reconstructive and plastic surgery

Aesthetic breast surgery is consistently a leading position in plastic surgery. According to the International Society of Aesthetic Plastic Surgery (ISAPS), in 2019, 1 795 551 breast augmentations were performed. However, as the number of primary surgeries increases, so does the percentage of complications and consequent patient dissatisfaction with the primary intervention results. Approximately 20% of women experience postoperative complications, such as breast asymmetry, implant displacement, double fold (“double bubble”), rippling, capsular contracture, seroma, hematoma, suture dehiscence, and others. Women with decreased breast tissue tone due to postinvolutive changes are at risk for postoperative complications. The risk of complications also increases when not just breast augmentation, but a combination of augmentation and mastopexy is required. In most cases, when a surgical intervention is recommended in several stages, patients are not willing to wait for a long time. This group of women is the most difficult for the clinician and therefore requires an analysis of all possible risk factors for complications development. Therefore, finding new possible ways to predict complications in reconstructive and plastic breast surgery is a relevant and priority direction.Purpose of a study: to develop a technique for preventing complications in reconstructive and plastic breast surgery.Material and methods. The results of 37 breast augmentation surgeries with T-shaped mastopexy in patients with different breast tissue density were analyzed, based on which an improved method of this operation was proposed. A comparative analysis of postoperative complications in early and late postoperative periods was carried out, and patients were surveyed before breast reconstruction and plastic surgery and 3, 6, and 12 months after plastic surgery to evaluate patient satisfaction with the outcome.Results. The analysis of the obtained data showed that breast tissue density plays a key role in choosing the tactics of breast augmentation with T-shaped mastopexy and is a predictor of complications development in the postoperative period.Conclusion. The planning of breast augmentation with T-shaped mastopexy should be carried out taking into account the determination of a patient's breast tissue density, which can affect the reduction of the risk of surgical complications during the surgery and in the postoperative period. The use of mastopexy technique with a preliminary marking of incisions with a margin of 1 cm to the central line from the classical V-shaped marking line is expedient in the presence of dense breast tissue in the patient.

Inferior and Medially Based Breast Parenchymal Rotation Flap: A New Mastopexy Technique for Replacing Breast Volume After Breast Implant Explantation.

Recently, a growing number of patients have been opting for the removal of breast implants. This often results in a degree of volume loss that can vary from mild to substantial, contingent on the size of the implant, with many patients requiring a mastopexy. Although autoaugmentation mastopexy serves as the primary surgical approach to restore shape and fill the void left by the implant, the fullness attained with the implant cannot be replicated through autoaugmentation. Our goal was to present the technical details and utilization of an inferomedial pedicle-based breast parenchymal flap, without rotational restriction from the parenchyma, for autoaugmentation after explantation. A retrospective chart review was performed of 12 patients who underwent surgery with this technique between the years of 2019 to 2022, with emphasis on reasons for explantation, early and late complications, and satisfaction scores on a Likert scale. Capsular contracture was the most common reason for explantation, and only 2 patients experienced minor wound dehiscence in the early postoperative period. With a mean follow-up of nearly 2 years, no bottoming out was encountered in any of the patients, and satisfactory breast shape was obtained. Further, postoperative satisfaction was significantly higher than preoperative satisfaction. The inferomedial-based parenchymal rotation flap is a new procedure that can be applied in this patient group because of its wide rotation arc and reliable vascularity. It is also an effective option for creating the desired conical breast shape in patients who do not want breast implants over the long term.

The Double-pedicle Tip Anchor Flap (DPTA-Flap) Preservation Technique for Autologous Breast Augmentation Circumvertical Mastopexy

The ultimate breast mastopexy technique allows a reliable and consistent transposition of the nipple-areolar complex (NAC) with preservation of nipple viability, sensation, and lactation potential. Ideally, good upper pole fullness with a durable result is achieved. However, as the inferior pole parenchyma often gravitates downward, the long-term result remains unsatisfactory. Anchoring remains a key procedure in autoaugmentation mammoplasty as the flap needs to be stable against gravity. We hereby describe a further refinement of a chest wall-based flap for the support of the upper pole, namely a double-pedicle tip anchor flap (DPTA-flap). By using this technique, good upper pole fullness is achieved, sensation is preserved, and lactation remains likely. Level of Evidence: V.

Ultrasound Guided Pecs II and Serratus Anterior Blocks as a Sole Anesthetic Technique for Reduction Mastopexy under Light Sedation in Elderly Female with Multiple Comorbidities

Ultrasound Guided Pecs II and Serratus Anterior Blocks as a Sole Anesthetic Technique for Reduction Mastopexy under Light Sedation in Elderly Female with Multiple Comorbidities

Experience and Indications for the Use of the P4HB Scaffold (GalaFLEX) in Aesthetic Breast Surgery: A 100-Case Experience.

The popularity of utilizing mesh in the breast has varied over the years. It is well described, and yet there has been poor uptake of its utilization in aesthetic breast surgery. Poly-4-huydroxybutarate (P4HB; GalaFLEX, Galatea, Lexington, MA) has recently been described as a useful adjunct in supporting poor tissue quality with positive early outcomes and low complication rates. The authors sought to determine the outcome and range of indications of PH4B in aesthetic breast surgery to document its effectiveness in assisting with long-term outcomes in mastopexy. Firstly, an observational study was undertaken standardizing mastopexy techniques with P4HB included in the procedure. Photographic measurements were taken to determine the extent of lower pole descent and lower pole stretch at 3 months and 1 year postoperative to observe change over time. Secondly, other indications were explored, including the correction of secondary defects such as inferior malposition and symmastia. The results of the mastopexy study were highly encouraging and comparable with those previously published in the literature, confirming sustained stability of the lower pole over time for mastopexies and implant mastopexies. In addition, the GalaFLEX was successfully employed in correcting many secondary defects. P4HB is extremely versatile and easy to utilize and has low complication rates. The results have led to a change in practice, with routine incorporation of GalaFLEX for all routine mastopexies. It has also replaced the utilization of acellular dermal matrices in aesthetic breast surgery.

Mastopexy and Abdominal Skin Excision with Liposuction.

INTRODUCTION Body contouring procedures are performed to treat excess skin following weight loss and have been associated with increased quality of life and improved body image.1 Mastopexy is indicated to treat breast ptosis and remains one of the most commonly performed plastic surgery operations in the United States.2 A number of skin excision patterns including the circumareolar, vertical, L-shaped, short-scar periareolar, and Wise-pattern have been described, with technique selection dependent on the degree of breast ptosis and amount and location of skin excess.3 Similar to a reduction mammoplasty, the nipple-areolar complex may be based on either a superomedial, medial, superior, inferior, lateral, or central pedicle.3 To treat abdominal skin excess, interventions ranging from a conservative excision of skin and fat to a traditional or fleur-de-lis abdominoplasty with fascial plication and umbilical transposition may be utilized depending on the degree and location of excess skin and fat as well as the presence of rectus diastasis.4 Finally, liposuction may be utilized with excisional treatment of abdominal skin excess to add improved contouring.5 Here, we present the case of a young woman who desired treatment of breast ptosis and excess abdominal skin and fat following weight loss. CASE REPORT A 19-year-old woman presented following approximately 50 pounds of weight loss with diet and exercise. She had been weight stable for over 1 year. She was noted to have bilateral grade II breast ptosis and a moderate amount of excess infraumbilical skin and fat with no hernias or rectus diastasis. She was deemed to be an excellent candidate for bilateral wise-pattern mastopexy with a superomedial pedicle and an excision of excess infraumbilical skin and fat, with additional liposuction of her axilla, abdomen, and flanks. Consent for the use of video and photograph images was obtained from the patient. Markings The patient was marked in a standing position (Video). (See Video [online], which demonstrates operative technique for bilateral mastopexy, abdominal skin and fat resection, and liposuction.) The sternal notch to nipple distance was 22 cm. The inferior border of the areola to inframammary fold (IMF) distance was 6 cm, and the width of the pedicle at its base was 8 cm. {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video 1.","caption":"The video demonstrates operative technique for bilateral mastopexy, abdominal skin and fat resection, and liposuction.","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_am59bf2h"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]} Surgical Technique The details of the operation are shown in the Video. Tumescent solution (1 L in total) was infiltrated before completion of the mastopexy, followed by liposuction, and finally, by abdominal skin and fat resection. DISCUSSION A Wise-pattern skin excision was chosen for the mastopexy, given the significant amount of vertical excess skin as well as ptosis. A more conservative skin resection pattern (eg, vertical) may have obviated the need for an IMF scar. A limited abdominal skin excision rather than an abdominoplasty with umbilical transposition was chosen to minimize dissection and potential complications (ie, umbilical necrosis, seroma from extensive undermining, etc). An abdominoplasty with umbilical transposition may have allowed for improved final umbilical positioning. CONCLUSIONS The patient was noted to be healing well at her 3 week postoperative visit and was very satisfied with her aesthetic outcome. Mastopexy may be safely performed in combination with abdominal skin resection and liposuction for such patients, avoiding a traditional abdominoplasty in young populations.

Outcome reporting in therapeutic mammaplasty: A systematic review

Introduction: Therapeutic mammaplasty (TM) is an oncological procedure, which combines tumour resection with breast reduction and mastopexy techniques. Previous systematic reviews have demonstrated oncological safety of TM, but inconsistent reporting of quality-of-life, aesthetic and functional outcomes. This systematic review aims to identify all outcomes reported in clinical studies of TM to facilitate development of a Core Outcome Set.

Therapeutic mammoplasty is associated with fewer long-term side-effects from breast radiotherapy

Background: Larger breast size and volume are predictors of clinically significant radiotherapy side-effects (toxicity). Therapeutic mammoplasty (TM) extends the role of breast-conserving surgery (BCS) by combining wide local excision of the cancer with breast reduction and mastopexy techniques. The aim of this study was to determine the effect of TM using level 2 oncoplastic techniques on the incidence of early and long-term radiotherapy toxicity.

Auto-Augmentation Mastopexy: Inferiorly Based Parenchymal Flap Technique and Evaluation of Outcomes Using BREAST-Q After 151 Consecutive Patients.

Mastopexy is one of the most performed annual plastic surgery procedures; hence, various techniques are described over the last decades. It varies from simple skin incisions to internally shaped pedicle designs. In this study, the authors present their modified auto-augmentation mastopexy technique and the resulting patient satisfaction. For this retrospectively conducted study, 151 female patients were included. The average age was 40.6 years (range, 27-72 years). All patients underwent auto-augmentation mastopexy which is a combination of a superior pedicle for the nipple-areola complex and an inferiorly based soft-tissue flap which is shaped like an implant. Additionally, the BREAST-Q for Reduction/Mastopexy was used to analyze patient-reported satisfaction and quality of life after mastopexy. All breast corrections were successfully performed. General complication rate was 9%, and no major complication was observed. In two patients, local surgical revision due to hypertrophic scarring and nipple asymmetry was necessary. Analysed surveys of the BREAST-Q showed statistically significantly improved results. Depending on the breast-shape and the grade of ptosis, the selection of mastopexy technique is crucial. Our described mastopexy procedure is a safe and easily reproducible technique for almost all shapes of ptotic breasts which fulfill patient desires as well as aesthetic satisfaction and quality of life. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Comparison of Classic Mastopexy Method with Double-Pedicled Auto-augmentation Mastopexywith Conic-Shaped Modified InferiorButterfly Flap.

In mastopexy surgery, extra skin and a specific amount of breast tissue are resected.Resected breast tissue is not in a large amount as in reduction surgery.In this study, we have investigated the results of an auto-augmentation mastopexy technique involving use of a superior pedicled mastopexy with conic-shaped inferior butterfly flap for augmentation without implant or fat injection. A total of 80 patients, 40 patients in each group, were included in the study. In the first group, double-pedicled auto-augmentation mastopexy with conic-shaped modified inferior butterfly flap technique was used. In the second group, conventional superior pedicled wise-pattern mastopexy was utilized. The results were evaluated from photographic measurements performed from standardized preoperative and postoperative lateral photographs. No major complications were seen such as partial or totalareola necrosis or breast volume loss. None of our patients has made a return with request for revision surgery. Minor complication seen in several patients was resolved with early intervention. The preoperative and postoperative photographic measurements of breast projection, upper pole projection, nipple position and lower pole level from preoperative and postoperative standardized lateral photographs revealed no significant difference between the groups. Weobtained highly satisfactory results for ourpatients. Following the surgery, our patients protected the cup sizes of their bra.In spite of the fact that there was no real augmentation performed in this procedure, effective straightening and the compact breast structure patients that achievedwere highly successful in creating an augmented breast image. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The Southern Surgical Arts Staple-Shape Mastopexy: A Technique for Improving Breast Ptosis

This article describes the mastopexy technique as used by multiple physicians at Southern Surgical Arts. The procedure is based off the tailor-tacking technique that has been modified to improve efficiency and consistency in obtaining cosmetically pleasing results. The procedure has proven to be safe when performing in combination with augmentation and other cosmetic procedure.