title: Augmentation Mastopexy with Implant and Autologous Tissue for Correction of Moderate/Severe Ptosis.
abstract: OBJECTIVE
  Breast augmentation combined with mastopexy is associated with a significantly higher complication rate than augmentation alone. The combination of mastopexy and breast implants has revealed a moderate recurrence of breast ptosis in many patients particularly with use of medium to large implants. Ptosis is the "bottoming out" of the breast tissue with loss of the desired roundness, due to the ptosis of the breast implant and the mammary tissue. In this study, we hypothesize the need for careful planning and careful preoperative surgical execution to minimize this complication.
  
  
  METHODS
  Between January 2007 and July 2011, augmentation mastopexy with implant and autologous tissue ("double implant") was performed for 25 patients with grade III mammary ptosis. All patients underwent inverted-T mastopexy with supramuscular moderately cohesive gel breast implant using an inferior-based flap of de-epitelialized dermoglandular tissue and a superior-based nipple-areola complex pedicle.
  
  
  RESULTS
  An inferior-based flap of deepithelialized dermoglandular tissue was used to stabilize the implant and is projection. Breast lifting was performed through a strong anchorage to fascia and to muscle of second intercostal space, improving the profile of the breast. Results were analyzed, no breast ptosis recurrence was noted at 30-month follow-up.
  
  
  CONCLUSIONS
  Our technique presents the challenge of determining the amount of excess skin to be removed after implantation to create symmetry and provide for skin tightening without compromising tissue vascularization.
authors: a Multidisciplinary Department of Medical-Surgical and Dental Specialties , Second University of Naples , Naples , Italy.
authors: Giuseppe Andrea
authors: GA
authors: Ferraro
authors: a Multidisciplinary Department of Medical-Surgical and Dental Specialties , Second University of Naples , Naples , Italy.
authors: Francesco
authors: F
authors: De Francesco
authors: a Multidisciplinary Department of Medical-Surgical and Dental Specialties , Second University of Naples , Naples , Italy.
authors: Sergio
authors: S
authors: Razzano
authors: a Multidisciplinary Department of Medical-Surgical and Dental Specialties , Second University of Naples , Naples , Italy.
authors: Francesco
authors: F
authors: D'Andrea
authors: a Multidisciplinary Department of Medical-Surgical and Dental Specialties , Second University of Naples , Naples , Italy.
authors: Gianfranco
authors: G
authors: Nicoletti
mesh_terms: D000328:Adult; D064592:Autografts / Q000637:transplantation; D001940:Breast / Q000098:blood supply / Q000601:surgery*; D019928:Breast Implantation / Q000009:adverse effects / Q000379:methods*; D018427:Breast Implants / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D057234:Preoperative Period; D012189:Retrospective Studies; D013524:Surgical Flaps
keywords: T inverted mastopexy; augmentation mastopexy; double implant; mammary implants; mammary ptosis