Lower Pole Dermoglandular Flap Autoaugmentation versus Mastopexy Augmentation with Subpectoral Implants: Outcomes after Reshaping of Ptotic Breasts | ||||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
| Article 7, Volume 45, Issue 3, July 2021, Page 157-167 PDF (26.07 MB) | ||||
| Document Type: Research article | ||||
| DOI: 10.21608/ejprs.2021.183866 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Issam Mohamed Elmekkawy* 1; Shabieb A. Abdelbaki2; Ahmed Mohamed Bahaa Eldin3; Mohamed Radwan El Hadidy3; Ahmed M. Zeina3 | ||||
| 1Specialist of Plastic Surgery, Ministry of Health | ||||
| 2The Department of Urology, , Faculty of Medicine, Benha University, Egypt | ||||
| 3Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Mansoura University, Egypt | ||||
| Abstract | ||||
| Background: Single stage augmentation mastopexy is a challenging procedure for both volume expansion and skin envelope reduction. Also, the patient experience is an important issue after mastopexy as it affects the patient physical functioning, psychosocial wellbeing, and the aesthetic result. Aim: To assess the outcomes of reshaping of a ptotic breast and its impact on the quality of life. Patients and Methods: This prospective comparative study was conducted over a 2-year period in 32 female patients with different degrees of breast ptosis. Patients were divided into two groups according to their desire to increase breast volume either using or not using an implant. Standard breast measurements as well as early and late complications were recorded, and patient satisfaction was assessed using the BREAST-Q. Results: Postoperatively, both the groups showed significant improvements in ptosis and in the BREAST-Q scores compared to pre-operative scores in all domains (p£0.001). However, regarding post-operative satisfaction with breast volume, psychosocial wellbeing, and outcomes, the autoaugmentation group showed a significantly higher BREAST-Q score compared with the implant augmentation group (p£0.05). Conclusion: The BREAST-Q provides significant clinical information and evaluates the influence of the surgical procedure on the patient's regular life activities. Mastopexy autoaugmentation using the lower pole dermoglandular flap is a reliable technique for enhancing the projection of the breast, improving the upper pole shape, and creating an adequate breast volume with a low complication rate and high patient satisfaction. | ||||
| Keywords | ||||
| Augmentation; Autoaugmentation; Breast; Mastopexy augmentation; Implant; Ptosis; Quality of life; Satisfaction | ||||
| References | ||||
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Rubin J.P. and Khachi G.: Mastopexy after massive weight loss: dermal suspension and selective auto-augmentation. Clinics in Plastic Surgery, 35 (1): 123-129, 2008. 2- Wueringer E. and TschabitscheR M.: New aspects of the topographical anatomy of the mammary gland regarding its neurovascular supply along a regular ligamentous suspension. European journal of morphology 40 (3): 181- 189, 2002. 3- Regnault P.: Breast ptosis: Definition and treatment. Clin. Plast. Surg., 3: 193-203. 1976. 4- Khavanin N., Jordan S.W., Rambachan A. and Kim J.Y.: A systematic review of singlestageaugmentationmastopexy. Plasticand Reconstructive Surgery, 134 (5): 922- 931, 2014. Egypt, J. Plast. Reconstr. Surg., July 2021 167 5- Troy, Jared, Little, Andrea, Kuykendall, Lauren, Dayicioglu and Deniz: Flap-Mastopexy in Autologous Breast Reconstruction: Timing and Technique. Annals of Plastic Surgery, 80 (4): 328-332, 2018. 6- Hall-Findlay E.J.: Aesthetic Breast Surgery: Concepts and Techniques. St. Louis, MO: Quality Medical Publishing, 429-514, 2011. 7- Di Summa P.G., Oranges C.M., Watfa W., Sapino G., Keller N., Tay S.K., Chew B.K., Schaefer D.J. and Raffoul W.: Systematic review of outcomes and complications in nonimplant-based mastopexy surgery. Journal of Plastic, Reconstructive & Aesthetic Surgery, 72 (2): 243-272, 2019. 8- Karacaoglu and Ercan: Single Stage Augmentation Mastopexy: A Novel Technique Using Autologous Dermal Graft. Annals of Plastic Surgery, 63 (6): 600-604, 2009. 9- Ors S.: Augmentation Mastopexy with a Dermal Encapsulated Round or Anatomic Autoprosthesis. Aesthetic Plastic Surgery, 42 (1): 88-97, 2018. 10- Cano S.J., Klassen A.F., Scott A.M. and Pusic A.L.: A closer look at the BREAST-Q©. Clinics in Plastic Surgery, 40 (2): 287-296, 2013. 11- Abboud L., Watfa W., di Summa P.G. and Raffoul W.: An original and simple autoaugmentation mastopexy in mild to moderate breast ptosis: Superior pedicle frontal division to achieve upper pole fullness. Gland Surgery, 6 (6): 751- 752, 2017. 12- Grünherz L., Burger A., Giovanoli P. and Lindenblatt N.: Long-term results measured by BREAST-Q reveal higher patient satisfaction after "autoimplant-mastopexy" than augmentation-mastopexy. Gland Surgery, 8 (5): 516-526, 2019. 13- American Society of Plastic Surgeons (ASPS): Plastic- Surgery-Statistics-Full-Report-2019. 1-25. https:// www.plasticsurgery.org/news/plastic-surgery-statistics. Accessed October 11, 2020. 14- Ribeiro L.: A new technique for reduction mammaplasty. Plastic and Reconstructive Surgery, 55 (3): 330-334, 1975. 15- Graf R. and Biggs T.M.: In search of better shape in mastopexy and reduction mammoplasty. Plastic and Reconstructive Surgery, 110 (1): 309-322, 2002. 16- Ritz M., Silfen R. and Southwick G.: Fascial suspension mastopexy. Plastic and Reconstructive Surgery, 117 (1): 86-94, 2006. 17- Botti G.: Vertical scar mammaplasty: Stable padding of the superior pole by means of a posteriorly based pedicle autoprosthesis. Aesthetic Surgery Journal, 19 (2): 116- 123, 1999. 18- Colwell, Amy, Breuing and Karl: Improving Shape and Symmetry in Mastopexy With Autologous or Cadaveric Dermal Slings. Annals of Plastic Surgery, 61 (2): 138- 142, 2008. 19- Kelemen N., Kannan R.Y. and Offer G.J.: A stacked technique of mastopexy: Volume redistribution mastopexy with inferior flap and superomedially based pedicle. Aesthetic Plastic Surgery, 37 (2): 349-353, 2013. 20- Hammond D.C. and O'Connor E.A.: The lower island flap transposition (LIFT) technique for control of the upper pole in circumvertical mastopexy. Plastic and Reconstructive Surgery, 134(4): 655-660, 2014. 21- Kirwan L., Wazir U. and Mokbel K.: Breast Auto- Augmentation: A Versatile Method of Breast Rehabilitation; Retrospective Series of 107 Procedures. Archives of Plastic Surgery, 42 (4): 438-445, 2015. 22- Lang Stumpfle, Rubem, Piccinini, Pedro, Pereira-Lima, Lucas, Valiati and Andre: Muscle-Splitting Augmentation- Mastopexy: Implant Protection with an Inferior Dermoglandular Flap. Annals of Plastic Surgery, 82 (2): 137-144, 2019. 23- Pirro O., Mestak O., Vindigni V., Sukop A., Hromadkova V., Nguyenova A., Vitova L. and Bassetto F.: Comparison of Patient-reported Outcomes after Implant Versus Autologous Tissue Breast Reconstruction Using the BREASTQ. Plastic and reconstructive surgery. Global Open, 5 (1): e1217, 2017. 24- Vindigni V., Scarpa C., Tommasini A., Toffanin M.C., Masetto L., Pavan C. and Bassetto F.: Breast Reshaping Following Bariatric Surgery. Obesity Surgery, 25 (9): 1735-1740, 2015. | ||||
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