Mastopexy with extended superior folded flap after implant removal
Goals/Purpose: Implant removal after breast augmentation is not rare condition and these operations can be performed for many reasons, including capsular contracture, rupture, uncontrolled asymmetry, presence of cancer or suspicious mass and mostly she no longer desires augmentation. Although removal of implant is very simple procedure, mastopexy after implant is very challenging application. In this presentation we share our experience with extended superior flap mastopexy in twelve cases after breast implant removal.
Methods/Technique: Twelve patients were operated with extended superior folded flap technique after their breast implant removal. All patients were operated under general anesthesia. Pre-operative marking were performed according to vertical scar superior pedicle technique and folded flap was designed before the operation. After removal of the implant folded flap was created to fullness of the upper part of the breast and sutured to the pectoral muscle fascia in the upper breast region. Standard closing of the pillars was performed classically.
Results/Complications: All patients were followed minimum 6 month post-operatively ( mean was 18 months).There was post-operative complication. We never performed re-operation. No patient requested extra volume in post-operative period. Patient satisfaction was achieved in all cases.
Conclusion: One of the most important sign of aesthetic breast is the fullness of the upper part of the breast. Although many maneuvers were described to maintain the fullness in superior part of the breast, most pleasing results were achieved with breast implants. Restoring of aesthetic breast shape after implant removal cannot be provided only standard mastopexy technique, but also fullness of the upper part of the breast should be preserved after implant removal. That means extra tissue is required for the fullness. Breast implants play a role as tissue expander and causes the enlargement of the breast soft tissue. Enlarged breast tissue can be easily used for the fullness of the upper part of the breast. Extended superior flap is very safe procedure and easy to perform. Successful results can be achieved with extended superior flap mastopexy after breast implant removal.
Figure 1 Pre and post-operative view of the patient
Figure 2 Per-operative view of the patient
Figure 3 Pre and post-operative view of the patient
Figure 4 Per-operative view of the patient
Figure 5 Pre-operative marking
Figure 6 Flap before folding
Figure 7 View of the breast at the end of operation
