Skip to main content
Top
Published in: Aesthetic Plastic Surgery 2/2018

01-04-2018 | Innovative Techniques

Mastopexy on Reconstructed Breast Following Massive Weight Loss: An Innovative Technique Using Dermo-Capsular Flaps

Authors: A. Cogliandro, M. Barone, G. Cassotta, R. Salzillo, P. Persichetti

Published in: Aesthetic Plastic Surgery | Issue 2/2018

Login to get access

Abstract

Background

We have developed a dermo-capsular flap mastopexy technique for patients who have experienced massive weight loss after breast reconstruction. The aim of this technique is to lift the inframammary fold, adequately cover the implant, and remove excess skin, elevating the breast and obtaining symmetry with the contralateral breast.

Methods

Between January 2014 and February 2017, we performed this technique on 20 women who were candidates for second-stage breast reconstruction following nipple-sparing mastectomy. All patients had experienced substantial weight loss (> 15 kg) and presented with ptosis after first-stage reconstruction.

Results

There were 8 patients with bilateral reconstruction following bilateral mastectomy (4 with bilateral nipple-sparing mastectomy). There were 12 patients with unilateral mastectomy, all with contralateral breast ptosis treated by augmentation via inverted-T mastopexy (n = 7) or crescent mastopexy (n = 5). The average lift of the nipple-areola complex was 5 cm (range 2–8 cm). The average follow-up was 12 months (range 4–36 months). Two patients had complications, including partial wound dehiscence (in a heavy smoker) and recurrence of breast asymmetry.

Conclusions

Implant breast reconstruction after massive weight loss is still possible even in the setting of thin, ptotic, and anelastic breast tissue. Our inverted-T dermo-capsular flap mastopexy technique for reconstructed breast is safe and effective with good outcomes and high patient satisfaction.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literature
1.
go back to reference Barone M, Cogliandro A, Persichetti P (2017) BREAST-Q following breast reconstruction: analysis of breast perception and sexuality. Plast Reconstr Surg 139:1016–1017CrossRef Barone M, Cogliandro A, Persichetti P (2017) BREAST-Q following breast reconstruction: analysis of breast perception and sexuality. Plast Reconstr Surg 139:1016–1017CrossRef
4.
go back to reference Persichetti P, Langella M, Filoni A, Cagli B, Tenna S (2013) How to redefine the inframammary fold: the “slingshot” capsular flap. Ann Plast Surg 70:636–638CrossRefPubMed Persichetti P, Langella M, Filoni A, Cagli B, Tenna S (2013) How to redefine the inframammary fold: the “slingshot” capsular flap. Ann Plast Surg 70:636–638CrossRefPubMed
5.
go back to reference Gargano F, Ciminello F, Podda S, De Santis G (2009) Salvage of exposed breast implants using capsular flaps. Eplasty 17(9):e41 Gargano F, Ciminello F, Podda S, De Santis G (2009) Salvage of exposed breast implants using capsular flaps. Eplasty 17(9):e41
6.
go back to reference Brandstetter M, Schoeller T, Pülzl P, Schubert H, Wechselberger G (2010) Capsular flap for coverage of an exposed implant after skin-sparring mastectomy and immediate breast reconstruction. Plast Reconstr Aesthet Surg 63:1388–1390CrossRef Brandstetter M, Schoeller T, Pülzl P, Schubert H, Wechselberger G (2010) Capsular flap for coverage of an exposed implant after skin-sparring mastectomy and immediate breast reconstruction. Plast Reconstr Aesthet Surg 63:1388–1390CrossRef
7.
go back to reference Gargano F, Moloney D, Arnstein P (2002) Use of a capsular flap to prevent palpable wrinkling of implants. Br J Plast Surg 55:269CrossRefPubMed Gargano F, Moloney D, Arnstein P (2002) Use of a capsular flap to prevent palpable wrinkling of implants. Br J Plast Surg 55:269CrossRefPubMed
8.
go back to reference Imran D, Javaid M, Lewis D, Attar KH (2005) Capsular flap for correction of contour deformities of the breast. Ann Plast Surg 54:662–663CrossRefPubMed Imran D, Javaid M, Lewis D, Attar KH (2005) Capsular flap for correction of contour deformities of the breast. Ann Plast Surg 54:662–663CrossRefPubMed
9.
go back to reference Hoch J, Stahlenbrecher A (2006) Bottoming out in augmentation mammaplasty-correction and prevention. Handchir Mikrochir Plast Chir 38:233–239CrossRefPubMed Hoch J, Stahlenbrecher A (2006) Bottoming out in augmentation mammaplasty-correction and prevention. Handchir Mikrochir Plast Chir 38:233–239CrossRefPubMed
10.
go back to reference Bogdanov-Berezovsky A, Silberstein E, Shoham Y, Krieger Y (2013) Capsular flap: new applications. Aesthetic Plast Surg 37:395–397CrossRefPubMed Bogdanov-Berezovsky A, Silberstein E, Shoham Y, Krieger Y (2013) Capsular flap: new applications. Aesthetic Plast Surg 37:395–397CrossRefPubMed
11.
go back to reference Bauder AR, Samra F, Kanchwala SK, Serletti JM, Kovach SJ, Wu LC (2017) Autologous breast reconstruction in the postbariatric patient population. Microsurgery 3 [Epub ahead of print] Bauder AR, Samra F, Kanchwala SK, Serletti JM, Kovach SJ, Wu LC (2017) Autologous breast reconstruction in the postbariatric patient population. Microsurgery 3 [Epub ahead of print]
12.
go back to reference Dayicioglu D, Tugertimur B, Munzenmaier K, Khan M, Smith P, Murr M, Kumar A, Khakpour N (2016) Outcomes of breast reconstruction after mastectomy using deep inferior epigastric perforator flap after massive weight loss. Ann Plast Surg 76(Suppl 4):S286–S289CrossRefPubMed Dayicioglu D, Tugertimur B, Munzenmaier K, Khan M, Smith P, Murr M, Kumar A, Khakpour N (2016) Outcomes of breast reconstruction after mastectomy using deep inferior epigastric perforator flap after massive weight loss. Ann Plast Surg 76(Suppl 4):S286–S289CrossRefPubMed
13.
go back to reference Martinez CA, Walters JA III, Sato EA, Hall JJ, Boutros SG (2016) Deep inferior epigastric artery perforator flap breast reconstruction in patients with previous bariatric surgery: Is it safe and feasible? Ann Plast Surg 76:216–220CrossRefPubMed Martinez CA, Walters JA III, Sato EA, Hall JJ, Boutros SG (2016) Deep inferior epigastric artery perforator flap breast reconstruction in patients with previous bariatric surgery: Is it safe and feasible? Ann Plast Surg 76:216–220CrossRefPubMed
14.
go back to reference Samra F, Bauder AR, Chin B, Taglienti A, Wes AM, Kanchwala SK, Serletti JM, Wu LC (2015) Autologous breast reconstruction in the post-bariatric patient population. Plast Reconstr Surg 136(4 Suppl):89–90CrossRefPubMed Samra F, Bauder AR, Chin B, Taglienti A, Wes AM, Kanchwala SK, Serletti JM, Wu LC (2015) Autologous breast reconstruction in the post-bariatric patient population. Plast Reconstr Surg 136(4 Suppl):89–90CrossRefPubMed
Metadata
Title
Mastopexy on Reconstructed Breast Following Massive Weight Loss: An Innovative Technique Using Dermo-Capsular Flaps
Authors
A. Cogliandro
M. Barone
G. Cassotta
R. Salzillo
P. Persichetti
Publication date
01-04-2018
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 2/2018
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-017-0992-y

Other articles of this Issue 2/2018

Aesthetic Plastic Surgery 2/2018 Go to the issue