Skip to main content
Top
Published in: Aesthetic Plastic Surgery 5/2010

01-10-2010 | Original Article

Mammaplasty with Inferior Pedicle Flap After Massive Weight Loss

Authors: Miguel Modolin, Wilson Cintra Jr., Maira Marques Silva, Liacyr Ribeiro, Rolf Gemperli, Marcus Castro Ferreira

Published in: Aesthetic Plastic Surgery | Issue 5/2010

Login to get access

Abstract

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/m2 (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.

Conclusion

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.
Literature
1.
go back to reference Orpheu SC (2009) Estudo histomorfométrico comparativo do colágeno e elastina na pele abdominal humana após perda ponderal maciça. [Tese de Mestrado]. Faculdade de Medicina, Universidade de São Paulo, São Paulo, p 87. Available at: http://www.teses.usp.br Orpheu SC (2009) Estudo histomorfométrico comparativo do colágeno e elastina na pele abdominal humana após perda ponderal maciça. [Tese de Mestrado]. Faculdade de Medicina, Universidade de São Paulo, São Paulo, p 87. Available at: http://​www.​teses.​usp.​br
2.
go back to reference Song AY, Jean DR, Hurwitz DJ, Fernstein MH, Scott JÁ, Rubin JP (2005) A classification of contour deformities after bariatric weight loss: the Pittsburgh Rating Scale. Plast Reconstr Surg 116(5):1535–1544CrossRefPubMed Song AY, Jean DR, Hurwitz DJ, Fernstein MH, Scott JÁ, Rubin JP (2005) A classification of contour deformities after bariatric weight loss: the Pittsburgh Rating Scale. Plast Reconstr Surg 116(5):1535–1544CrossRefPubMed
4.
go back to reference Ribeiro L, Accorsi A, Buss A, Marçal-Pessoa M (2002) Creation and evolution of 30 years of the inferior pedicle in reduction mammaplasties. Plast Reconstr Surg 110(3):960–970CrossRefPubMed Ribeiro L, Accorsi A, Buss A, Marçal-Pessoa M (2002) Creation and evolution of 30 years of the inferior pedicle in reduction mammaplasties. Plast Reconstr Surg 110(3):960–970CrossRefPubMed
5.
go back to reference Wise RJ (1956) Preliminary report on a method of planning the mammaplasty. Plast Reconstr Surg 17(5):367–375CrossRef Wise RJ (1956) Preliminary report on a method of planning the mammaplasty. Plast Reconstr Surg 17(5):367–375CrossRef
6.
go back to reference Hurwitz DJ, Agha-Mohammadi S (2006) Postbariatric surgery breast reshaping: the spiral flap. Ann Plast Surg 56(5):481–486CrossRefPubMed Hurwitz DJ, Agha-Mohammadi S (2006) Postbariatric surgery breast reshaping: the spiral flap. Ann Plast Surg 56(5):481–486CrossRefPubMed
7.
go back to reference Rubin JP, Khachi G (2008) Mastopexy after massive weight loss: dermal suspension and selective auto-augmentation. Clin Plast Surg 35(1):123–129CrossRefPubMed Rubin JP, Khachi G (2008) Mastopexy after massive weight loss: dermal suspension and selective auto-augmentation. Clin Plast Surg 35(1):123–129CrossRefPubMed
8.
go back to reference Losken A, Holtz DJ (2007) Versatility of superomedial pedicle in managing the massive weight loss breast: the rotation-advancement technique. Plast Reconstr Surg 120(4):1060–1068CrossRefPubMed Losken A, Holtz DJ (2007) Versatility of superomedial pedicle in managing the massive weight loss breast: the rotation-advancement technique. Plast Reconstr Surg 120(4):1060–1068CrossRefPubMed
9.
go back to reference Silveira Neto E (1976) Mastoplastia setorial com pediculo areolar interno. Anais do XIIIth Congresso Brasileiro de Cirurgia Plástica, Porto Alegre, November 1976, p 13 Silveira Neto E (1976) Mastoplastia setorial com pediculo areolar interno. Anais do XIIIth Congresso Brasileiro de Cirurgia Plástica, Porto Alegre, November 1976, p 13
10.
go back to reference Graf R, Biggs TM (2002) In search of better shape in mastopexy and reduction mammaplasty. Plast Reconstr Surg 110(1):309–317CrossRefPubMed Graf R, Biggs TM (2002) In search of better shape in mastopexy and reduction mammaplasty. Plast Reconstr Surg 110(1):309–317CrossRefPubMed
11.
go back to reference Cintra W Jr, Modolin ML, Gemperli R, Gobbi CI, Faintuch J, Ferreira MC (2008) Quality of life after abdominoplasty in women after bariatric surgery. Obes Surg 18:728–732CrossRefPubMed Cintra W Jr, Modolin ML, Gemperli R, Gobbi CI, Faintuch J, Ferreira MC (2008) Quality of life after abdominoplasty in women after bariatric surgery. Obes Surg 18:728–732CrossRefPubMed
12.
go back to reference Ferreira MC (2000) Evaluation of results in aesthetic plastic surgery: preliminary observations on mammaplasty. Plast Reconstr Surg 106(7):1630–1635CrossRefPubMed Ferreira MC (2000) Evaluation of results in aesthetic plastic surgery: preliminary observations on mammaplasty. Plast Reconstr Surg 106(7):1630–1635CrossRefPubMed
13.
go back to reference Jurado J (1979) The vertical dermal-glandular flap of the inferior single pedicle in breast surgery. Transactions of the VIIth international congress of plastic reconstructive surgery, Rio de Janeiro, 1979, p 557 Jurado J (1979) The vertical dermal-glandular flap of the inferior single pedicle in breast surgery. Transactions of the VIIth international congress of plastic reconstructive surgery, Rio de Janeiro, 1979, p 557
14.
go back to reference Mckissock PK (1972) Reduction mammaplasty with vertical dermal flap. Plast Reconstr Surg 49(3):245–252CrossRefPubMed Mckissock PK (1972) Reduction mammaplasty with vertical dermal flap. Plast Reconstr Surg 49(3):245–252CrossRefPubMed
15.
go back to reference Ribeiro L, Rocha RB (2008) Intercorrência em mamoplastia redutora. In: Resen JH (ed) Tratado de Cirurgia Plástica na Obesidade. Ed. Rubio, Rio de Janeiro, pp 381–394 Ribeiro L, Rocha RB (2008) Intercorrência em mamoplastia redutora. In: Resen JH (ed) Tratado de Cirurgia Plástica na Obesidade. Ed. Rubio, Rio de Janeiro, pp 381–394
Metadata
Title
Mammaplasty with Inferior Pedicle Flap After Massive Weight Loss
Authors
Miguel Modolin
Wilson Cintra Jr.
Maira Marques Silva
Liacyr Ribeiro
Rolf Gemperli
Marcus Castro Ferreira
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Aesthetic Plastic Surgery / Issue 5/2010
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-010-9516-8

Other articles of this Issue 5/2010

Aesthetic Plastic Surgery 5/2010 Go to the issue