Mammaplasty for patients who have experienced massive weight loss involves some concepts that differ from those that apply to mammaplasty for normal patients. Breast anatomic characteristics make this procedure a very challenging situation. The authors present their experience with a new mammaplasty technique using an extended thoracic wall flap associated with a loop of pectoralis. This procedure is a simple and reproducible method for patients with massive weight loss that results in a pleasing breast shape and long-lasting results.

The preservation of axillary lymphatic drainage after TBA allowed for SN detection in all studied breasts. It seems that the applied surgical technique played an important role in axillary lymphatic integrity.

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