The 10-Year Experience with Volume Distribution Mastopexy: A Novel, Safe, and Efficient Method for Breast Rejuvenation

Abstract

Background: Recurrent ptosis may occur after mastopexy procedures over time. The volume distribution mastopexy technique provides breast lifting with projection enhancement and maintains breast suspension. Method: Since 2010, 50 patients underwent volume distribution mastopexy procedures. The technique consists of a superior or superomedial pedicle, dissection of a Würinger-septum-based chest wall flap, suspension of the flap to the pectoralis major muscle using a prosthetic mesh, gland suture to the mesh, and fat grafting if required. A prospective study was conducted. Nipple position and length of the lower pole distance of the breast were noted. Patient satisfaction and results evaluation were reported using a Likert scale. Results: A Vicryl mesh was used in the first 23 patients and a mixed polyester/ Vicryl mesh was used in the following 27 patients. Wound dehiscence occurred in one patient. At an average follow-up of 3 years, nipple position remained stable in position, but lower pole distance elongation was observed in five patients (20 percent) and in one patient (3 percent) who had Vicryl mesh and mixed mesh respectively (p < 0.05). Only four breasts (4.7 percent) demonstrated significant lower pole elongation over time (>15 percent), all in the Vicryl mesh group. Worth noting, both the patients and the independent evaluators provided high ratings of the result of 4.7 and 4.6, respectively, on a Likert scale. Conclusions: The volume distribution mastopexy technique repositions the ptotic gland with a mesh to suspend the breast gland and to maintain the lifting effect. However, the synthetic mixed mesh proved to be significantly more effective in achieving this goal.

The Versatility of the Lateral-based Mammary Flap as an “Auto-implant” for Enhancing Breast Mound for Patients Undergoing Primary Mastopexy

“…In a systematic review of 43 studies published from 1980 to 2016, including 1888 patients treated with mastopexy techniques, di Summa et al 26 noted a complication rate of 10.4%, a bottoming out rate of 1.5%, and high patient satisfaction with relatively low complication rates. Hamdi et al 27 used the volume distribution mastopexy method for 50 patients over 10 years through a superior or superomedial pedicle and followed up the patients for 3 years. They reported that the nipple site gradually stabilized, and the elongation of the inferior pole was observed in five cases (20%).…”

Longevity of ptosis correction in mastopexy and reduction mammaplasty: A systematic review of techniques

“… 16 All other studies incorporating the vertical reduction pattern reported the elongation of the lower inframammary pole length, bottoming out, or increase in pseudoptosis over the study period. 2 , 6 , 9 , 17 , 18 , 19 , 20 …”

“…These include pillar sutures, permanent and absorbable meshes, lipofilling, dermal or dermoglandular slings, autoaugmentation flaps, and muscular slings. 2 , 3 , 4 , 6 , 9 , 11 , 15 , 16 , 17 , 18 , 20 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 The meshes used were variable and permanent or partially absorbable meshes generally had better outcomes compared to fully absorbable meshes. Hamdi et al.…”

“…compared results in patients who underwent superior or superomedial pedicle mastopexy with a septum-based parenchymal flap supported by Vicryl or mixed polyester/Vicryl mesh and found a significantly greater lower pole elongation with Vicryl mesh. 17 József et al. compared results of contralateral mastopexy symmetry procedures after breast reconstruction using no mesh or ULTRAPRO® partially absorbable mesh, and the no mesh group was found to have a significantly increased SN-N and N-IMF elongation.…”

Combined superior and inferior dermoglandular flaps for projection enhancement in giantic breast amputation and free nipple areola graft

“…pedicle, skin-resection pattern, & parenchymal-resection pattern should all be taken into account separately while doing breast reduction. (13) superior pedicle, inferior pedicle, lateral pedicle, horizontal bipedicle, vertical bipedicle, & superomedial pedicle are 6 primary pedicles that are discussed. When Robert Wise created an inverted T skin resection pattern in 1956, he made significant advancements in the field of skin resection patterns by adapting the brassiere design.…”