Inferior Pedicle Autoaugmentation Mastopexy After Breast Implant Removal

Abstract

BackgroundA new method of autoaugmentation mammaplasty is presented to correct ptosis and to increase the projection and volume of the breast in patients who would like a reposition augmentation mammaplasty after breast implant removal but do not want a new implant.MethodsBetween 1999 and 2007, a total of 27 patients (age = 54 ± 7.3 years) underwent mammaplasty using an inferior-based flap of deepithelialized subcutaneous and breast tissue modularized to its pedicle which was inserted beneath a superior pedicle used for correction of ptosis and to increase the projection and apparent volume of the breast.ResultsThe results confirmed that autoaugmentation mammaplasty of the breast following removal of the implant yields longstanding results. It corrects ptosis and increases the projection and apparent volume of the breast when mastopexy is planned without use of a new implant. Twelve months after surgery the degree of descent of the inframammary fold generally parallels that of the nipple. The mean level of the inframammary fold was below the mean level of the nipple. Postoperatively, the optimum distance had been largely achieved.ConclusionThe advantages of the technique presented here are that it minimizes the skin scar in cases using vertical mammaplasty techniques and optimizes the breast shape after breast implant removal in patients who do not want a new implant.

Adjunctive Procedures and Informed Consent with Breast Implant Explantation

“…Melmed advocates for a periareolar Benelli-like approach. 10 Hönig et al 30 report a dual pedicle mastopexy technique utilizing central breast access to explantation, a superior or superomedial pedicle for nipple positioning, limited wise pattern or vertical skin resection, and a translocated inferior dermoglandular pedicle for central and upper breast shaping and sizing, decreasing ptosis and increasing projection. They specifically report use of the capsule for support of the repositioning and report acceptable appearance 1 year postoperatively.…”

“…26 Many other authors report various other autoaugmentation techniques in concert with mastopexy which could be considered applicable to explantation scenarios. 30,[36][37][38][39][40][41][42][43][44] Careful physical evaluation will impact surgical options. Inferior pedicle techniques are suboptimal for patients with overly large implants and…”

Combined Breast Implant Explantation and Multilevel Mastopexy Technique

“…Multiple publications have described approaches to the breast autoaugmentation patient designed to maximize aesthetic outcomes and minimize the likelihood of complications and reoperations. 3–5 Breast implant explantation leaves behind a wide deflated breast with very little breast tissue barely resembling the former breast form. 3–5…”

“…3–5 Breast implant explantation leaves behind a wide deflated breast with very little breast tissue barely resembling the former breast form. 3–5…”

Breast Auto-Augmentation: A Versatile Method of Breast Rehabilitation—A Retrospective Series of 107 Procedures

“…Furthermore, the peri-areolar purse-string reduced tension and risk of vascular compromise of the nipple areolar complex (NAC). The technique was named 'Breast Auto-augmentation' (BAA) as used in subsequent papers [ 10 11 ]. In the original paper [ 3 ] the BAA technique was used in a case of explantation.…”