Abstract:
The reasons for recurrent ptosis in mastopexy
and breast reduction procedures are twofold. First,
available surgical techniques do not reconstruct the normal
breast anatomy responsible for maintaining breast shape.
Second, in many instances the techniques rely on atrophied
tissue to provide long-term support. The discovery in 1997
of the ligamentous suspension (the supporting system of
the breast) gave rise to the concept that reconstruction of
this anatomical structure was needed to ensure a sustained
postoperative result. Applying the latest knowledge
regarding the structural and vascular anatomy of the breast
in the surgical technique and utilizing material other than
atrophied breast tissue enabled us to prevent the recurrence
of breast ptosis.
Methods A surgical technique was developed to replace
the supportive function of a failed ligamentous suspension
in 112 patients with ptotic breasts. This was done by reconstructing an internal breast-supporting system (IBSS)
with biocompatible mesh.
Results Satisfactory breast shape, nipple projection, and
upper breast fullness was obtained with this technique in
mastopexy patients with moderate-sized ptotic breasts. In
patients with larger breasts good results were obtained with
a simultaneous breast reduction. The longest follow-up is
6 years 3 months.
Conclusions With this technique recurrent breast ptosis can
be prevented in mastopexy and breast reduction procedures.
The results are such that it eliminates the need for silicone
prostheses to obtain satisfactory upper-breast fullness. The
surgical technique is especially indicated in patients with skin
of poor quality or patients with high expectations.
