Use of the P4HB Scaffold (GalaFLEX) in Mastopexy Surgery: Novel Inset Technique to Optimize Soft Tissue Support

Goals/Purpose: Poly-4-huydroxybutarate (P4HB) has been well described in aesthetic and reconstructive breast surgery to support soft tissue in the ptotic breast. Despite its proposed benefits, its utilization remains limited partly due to inexperience with use and lack of consensus for optimal inset. Previous studies have focused on support of the lower pole of the ptotic beast. We present a novel and easy inset technique of P4HB scaffold (GalaFLEX, Galatea, Lexington, MA) to support the entire breast during mastopexy procedure.

Methods/Technique: The authors offer a novel and simple technique to inset P4HB scaffold in aesthetic mastopexy surgery. We share our experience and immediate postoperative outcomes.

Technique: A sheet of P4HB scaffold (GalaFLEX Lite) is placed along the base of the breast and secured along the breast fold. The superior aspect of the P4HB scaffold is then parachuted up beneath the mastectomy skin flaps and secured with barbed suture through the skin. A split is made in the mesh to release the nipple. The skin flaps are then draped over the breast mound and skin.

Results/Complications: All Mastopexy patients who underwent proposed technique were included in this study. A total of 10 patients were selected who met inclusion criteria. We retrospectively reviewed patients charts for primary outcomes, pre- and post-operative photos for breast position and aesthetic result.

Conclusion: P4HB scaffold is an excellent tool that is well described in aesthetic beast surgery. Despite its proposed benefits it’s remains limited secondary to inexperience and lack of consensus on inset. Out proposed inset technique is easy to use and helps maintain breast position after mastopexy surgery with minimal complications.