title: Simple Reshaping of the Breast in Massive Weight Loss Patients: Promising Preliminary Results.
abstract: BACKGROUND
  The challenging breast reshaping after massive weight loss (MWL) has been increasingly performed as the number of bariatric surgery procedures increase worldwide. The breasts often appear wide, lateralized, and deflated, with significant ptosis.
  
  
  OBJECTIVE
  The aim of this article is to share our initial experience using the lower pole subglandular advancement mastoplasty (LOPOSAM) technique to reshape the breasts in MWL patients and to elaborate the technical details and simplicity of the method in the attached video.
  
  
  METHODS
  We performed 30 LOPOSAM procedures in 15 MWL women aged 24 to 63 years from February to September 2015. We used a wise pattern mark-up and a superior based pedicle for the relocation of the nipple areola complex. The key step for the autoaugmentation was an inferior and central mound based parabola-shaped flap, which was placed in a subglandular pocket to reshape the breast and lift the inframammary crease.
  
  
  RESULTS
  The median operation time for the LOPOSAM procedure was 81 minutes (range, 35-160 minutes) by 2 surgeons. The median weight loss was 64 kg (range, 45-103) and 22 body mass index units (range, 16-33) per patient. The median follow-up was 240 days (range, 105 Powered by Editorial Manager and ProduXion Manager from Aries Systems Corporation to 345). The surgical goal was achieved in all cases. Four complications occurred in 3 patients, 1 major, a hematoma-requiring surgery and 3 minor wound dehiscence. The self-reported patient satisfaction was high, 13 were very satisfied with the result, 1 satisfied, and 1 less satisfied.
  
  
  CONCLUSIONS
  The LOPOSAM technique is quick and simple to perform, and the preliminary results are promising. However, a longer follow-up is needed to confirm this.
authors.affiliation: From the *Department of Plastic and Reconstructive Surgery, Odense University Hospital, Odense, Denmark; †Department of Plastic Surgery, Telemark Hospital, Skien, Norway; ‡Clinic for Plastic Surgery, Mølhom Private Hospital, Vejle, Denmark; §Division of Plastic Surgery, Mount Sinai Medical System, New York, NY; ∥Department of Plastic Surgery, Lillebaelt Hospital, Vejle & Odense University Hospital, Odense, Denmark.
authors.forename: Peder
authors.initials: P
authors.lastname: Ikander
authors.forename: Dorte
authors.initials: D
authors.lastname: Gad
authors.forename: Gudjon Leifur
authors.initials: GL
authors.lastname: Gunnarsson
authors.forename: Slaven
authors.initials: S
authors.lastname: Boljanovic
authors.forename: Andrew
authors.initials: A
authors.lastname: Salzberg
authors.forename: Jens Ahm
authors.initials: JA
authors.lastname: Sørensen
authors.forename: Jørn Bo
authors.initials: JB
authors.lastname: Thomsen
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011446:Prospective Studies; D015431:Weight Loss; D061217:Weight Reduction Programs