The medial‐central septum based mammaplasty: A reliable technique to preserve nipple‐areola complex sensitivity in post bariatric patients

Abstract

Introduction Massive weight loss is associated with the ptosis of the breast, loss of the upper pole fullness, medialization of the nipples and volume depletion. Post bariatric patients often need breast reshaping with mastopexy or breast reduction. We report the author's experience with the medial central septum based mammoplasty for breast reshaping after massive weight loss. Methods We retrospectively reviewed the records of 85 women who underwent a medial‐central septum based mammaplasty, analyzing patients (age, BMI, comorbidities) and operation specific characteristics’ (surgical technique, complications) to identify the advantages and the drawbacks of the adopted technique. All the procedures were performed at a single institution by the senior author of this article. Results 85 patients were included in the review, in total 170 medial‐central septum based mammaplasty were performed over a five years period. Early complications, as hematoma and seroma occurred in 2 patients. No total or partial nipple‐areola losses were recorded and the viability of the nipple‐areola complex (NAC) was excellent in all the treated patients. Sensation was retained in all breasts. Nine patients showed delayed wound healing at the joint of the T scar; in 5 patients we observed spreading scars. Conclusion The medial‐central septum based mammaplasty seems to be an effective and safe choice for breast reshaping after massive weight loss, as none of our patients experienced nipple loss and all of them reported good nipple sensation. Moreover, the technique is versatile and can be applied to patients with hypertrophic breasts or gigantomastia.

The management of breast implant-associated anaplastic large cell lymphoma in the setting of pregnancy: seeking for clinical practice guidelines

“…After the diagnosis and surgical treatment of BIA-ALCL, it has been recommended that only autologous reconstruction would be offered until further evidence is gathered [16][17][18][19]. However, our patient refused any autologous breast augmentation.…”

“…In our case, the decision to postpone the treatment after childbirth did not change the patient's stadiation and prognosis. Indeed PET/CT scan, which was not performed before childbirth as PET with 18 F-fluorodeoxyglucose tracer exposes the fetus to a high dose of radiation and is not recommended during pregnancy [15], confirmed a stage IA disease. Patient was treated with complete surgical bilateral excision of implants and their surrounding fibrous capsule because an estimated 4.6% of BIA-ALCL cases to date have demonstrated incidental ALCL in the contralateral breast implant [3].…”