Improving the Longevity and Results of Mastopexy and Breast Reduction Procedures: Reconstructing an Internal Breast Support System with Biocompatible Mesh to Replace the Supporting Function of the Ligamentous Suspension

Abstract

BackgroundThe reasons for recurrent ptosis in mastopexy and breast reduction procedures are twofold. First, available surgical techniques do not reconstruct the normal breast anatomy responsible for maintaining breast shape. Second, in many instances the techniques rely on atrophied tissue to provide long-term support. The discovery in 1997 of the ligamentous suspension (the supporting system of the breast) gave rise to the concept that reconstruction of this anatomical structure was needed to ensure a sustained postoperative result. Applying the latest knowledge regarding the structural and vascular anatomy of the breast in the surgical technique and utilizing material other than atrophied breast tissue enabled us to prevent the recurrence of breast ptosis.MethodsA surgical technique was developed to replace the supportive function of a failed ligamentous suspension in 112 patients with ptotic breasts. This was done by reconstructing an internal breast-supporting system (IBSS) with biocompatible mesh.ResultsSatisfactory breast shape, nipple projection, and upper breast fullness was obtained with this technique in mastopexy patients with moderate-sized ptotic breasts. In patients with larger breasts good results were obtained with a simultaneous breast reduction. The longest follow-up is 6 years 3 months.ConclusionsWith this technique recurrent breast ptosis can be prevented in mastopexy and breast reduction procedures. The results are such that it eliminates the need for silicone prostheses to obtain satisfactory upper-breast fullness. The surgical technique is especially indicated in patients with skin of poor quality or patients with high expectations.

Porcine-derived acellular dermal matrix in primary augmentation mammoplasty to minimize implant-related complications and achieve an internal mastopexy: a case series

“…As with any cosmetic elective procedure, the costs and risk to benefit ratio must be carefully weighed in such cases. The current surgical use of PADM is similar to that described in a recent report of the successful use of ADM as an internal bra for patients with ptosis undergoing primary mastopexy, either alone or in combination with breast reduction [8]. The current findings supplement those of this earlier study and suggest that PADM also may be used in similar patients who wish to undergo breast implant surgery.…”

Dermo-Fascial Suspension in Mastopexy for Improvement of Aesthetic Outcomes

“…Statistical analysis showed that there is a high statistical significance difference between three measurements of SN distance. The mean values and standard deviation of the N-IMF distances are shown in Tables (3,4). Statistical analysis showed that there is a high statistical significance difference between three measures of N-IMF distance.…”

“…Breast ptosis results from weakening and lengthening of the supporting structures of the breast [4]. Therefore, correction of ptosis and restoring youthful breasts remains a challenge in breast aesthetic surgery.…”

Risks and Benefits of Using an Absorbable Mesh in One-Stage Immediate Breast Reconstruction

“…[21][22][23]31 Therefore, a one-stage procedure has been proposed with extension of the submuscular pocket by release of the inferior pectoralis major attachments and its completion by a foreign material such as biological matrices or synthetic mesh. [34][35][36] This surgical experience has demonstrated good tolerance of this foreign material. [34][35][36] This surgical experience has demonstrated good tolerance of this foreign material.…”