Structural Mastopexy: Volume Displacement in Breast Reshaping

Background: Although in breast reshaping, the restoration of a suitable mammary cone is the main goal of the procedure, long-lasting upper pole fullness preservation is the most common weak point of all mastopexy. Mastopexy is a challenging procedure, and a surgical procedure to create desirable long-lasting results has not been well standardized. In this paper, the authors report their experiences in structural mastopexy procedures, describing three different adipo-glandular flaps, each repositioned as auto-prosthesis to reshape upper pole contour in patients affected by a severe degree of breast ptosis. Methods: A 6-year retrospective iconographic-chart and review was performed on 89 patients undergoing mastopexy between January 2016 and December 2021. Surgical candidates reported grades 2 and 3 of ptosis following Regnault classification. Minimum follow-up was 24 months. Pre- and postoperative data for all patients were collected in the same standard conditions. Results: 89 patients affected with bilateral breast ptosis were included in the study, for a total of 178 breasts. Patients’ mean age at the time of surgery was 40.45 years, ranging between 28 and 59 years. Follow-up ranged between 2 and 6 years with an average of 47.13 months. Out of 89 patients, 50 underwent general anesthesia, and the remaining 39 underwent local anesthesia. Among the 178 treated breasts, 10 (17.8%) experienced minor complications: No major complications were reported. Conclusion: Autologous tissue displacement, collecting parenchyma wherever surplus can be recruited, permits the transfer of extra tissue to the lack of volume, recontouring satisfactory breast shape and ensuring long-lasting results. Level of Evidence V: 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.