title: One stage mastopexy augmentation in the ptotic patient. The superiorly based dermal flap for autologous reinforcement of the inferior pole.
abstract: BACKGROUND
  The use of one stage mastopexy augmentation in the ptotic patient remains controversial. Expansion of breast volume and reduction of the skin envelope contradict each other and increase the risks of potential complications. By carefully selecting and consenting patients appropriately I describe the use of the superiorly based dermal flap for autologous reinforcement of the inferior pole to increase safety and reliability in one stage mastopexy augmentation.
  
  
  OBJECTIVE
  To determine whether the superiorly based dermal flap could provide a safe and reliable method of one stage mastopexy augmentation.
  
  
  METHODS
  40 one staged mastopexy augmentation procedures were performed on 21 patients. Patients were excluded if they smoked, BMI >30, had significant co-morbidities, had unrealistic expectations, required a nipple lift of >8 cm, wanted >400cc volume in primary cases or >25% increase in volume in secondary mastopexy augmentation. Both round and anatomical implants were used in either the sub glandular or dual plane pocket depending on patient's aesthetic wishes.
  
  
  RESULTS
  The average implant size was 290cc and average nipple lift was 5 cm. After an average follow up of 27months there have been no implant based complications, no reoperations and no infections/haematomas/seromas.
  
  
  CONCLUSIONS
  Careful selection and consent of patients make the use of the superiorly based dermal flap for autologous reinforcement of the inferior pole a safe reliable technique in one stage mastopexy augmentation.
authors.affiliation: University of Manchester, Institute of Cancer Sciences, The University of Manchester, Oxford Road, Manchester M13 9PL, UK. Electronic address: glross@gmail.com.
authors.forename: Gary L
authors.initials: GL
authors.lastname: Ross
mesh_terms: D000328:Adult; D000368:Aged; D018427:Breast Implants; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps / Q000637:transplantation*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult
keywords: Augmentation mastopexy; Breast ptosis; Dermal flap; Implants; Mastopexy