Mammaplasty with inferior pedicle flap after massive weight loss.
BACKGROUND
After massive weight loss, one of the stigmas that afflict women is the remaining deformity of the breasts which become flaccid and ptotic, with an absent or flat upper pole. The authors propose the use of a well-established mammaplasty technique to fill the upper pole, reshape the breast cone, and correct ptosis with nipple-areola complex (NAC) repositioning.


METHODS
A total of 16 patients were analyzed; all underwent gastroplasty between 18 and 24 months prior to mammaplasty. The mean age was 41.6 years (range = 26-62) and the mean BMI previous to the mammaplasty was 29.2 kg/m(2) (range = 24.9-38.9). The technique included a dermo-lipo glandular flap pedicled on the inframammary fold (IMF) together with a superior flap containing the NAC.


RESULTS
All patients who underwent surgery were satisfied with the outcomes since a more aesthetic breast shape was achieved, with projection of the upper pole and correction of ptosis. Adverse events included dehiscence at the junction point of the flaps in the inframammary fold, which resolved with secondary-intention wound healing in three patients; partial necrosis of the areola in one patient; epidermolysis in one of the NACs in one patient; and infection in one of the breasts in one patient, which resolved with proper antibiotic therapy.


CONCLUSIONS
When compared to the current mammaplasty techniques performed in formerly obese patients, this is a good surgical option because it uses tissues adjacent to the breast itself and does not require silicone prosthesis for breast augmentation. The patients reported increased self-esteem and improvement in their quality of life.
Modolin
Miguel
M
Division of Plastic Surgery, University of São Paulo School of Medicine, Rua Canadá, 89, São Paulo, SP, 01436-000, Brazil. miguelmodolin@uol.com.br
Cintra
Wilson
W
Silva
Maira Marques
MM
Ribeiro
Liacyr
L
Gemperli
Rolf
R
Ferreira
Marcus Castro
MC
D000328:Adult; D001940:Breast / Q000601:surgery*; D005260:Female; D015391:Gastroplasty; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D013524:Surgical Flaps; D016896:Treatment Outcome; D015431:Weight Loss