Mastoplastia de aumento com inclusão de implante de silicone associado a mastopexia com abordagem inicial periareolar (safety pocket)

Abstract

Augmentation mastoplasty with silicone implant associated with mastopexy through an initial periareolar approach Augmentation mastoplasty with silicone implant associated with mastopexy through an initial periareolar approach (safety pocket) Mastoplastia de aumento com inclusão de implante de silicone associado a mastopexia com abordagem inicial periareolar (safety pocket) ABSTRACT Background: Mastopexy with breast implant surgery is a challenging and highly complex surgical procedure. In Brazil, there is growing interest in larger breast volumes, although in certain cases, the sole addition of silicone implants is not sufficient for constructing a conical breast with a full upper pole. To obtain this result, it is necessary to correct sagging breasts by removing excess skin. Methods: The initial approach was made with an inferior semicircular periareolar incision, which provided subfascial access to the breast pocket for inclusion of the implant. After implant placement, the excess skin was marked using simple stitches and staining with methylene blue prior to resection. Longitudinal spindle marking was preferred whenever possible. However, "L" or inverted "T" markings were also used when excess skin amounts were greater. Results: We analyzed 49 patients aged 20-68 years, of whom 28 were undergoing primary breast surgery and 21 were undergoing secondary breast surgery. The surgeries for breast pexia included L-shaped scars in 23 patients, T-shaped scars in 8 patients, and vertical scars in 18 patients. Six complications were observed in this group of patients: hematoma (n = 2), scar retraction (n = 2), severe ecchymosis (n = 1), and steatonecrosis (n = 1). Conclusions: The conservative skin removal approach after prosthesis implantation, periareolar access, and use of the subfascial plane are the differential and relevant points of this technique. This technique is also considered safer because the periareolar incision caused the only loss of continuity in the tissues. Therefore, the prosthesis was not exposed during mastopexy.