Objectives: The goal was to find reasons for drooping of the breast, elevated by mastopexy
Introduction: Whoever speaks about vertical mastopexy would surely claim higher projection, fuller upper pole and long standing results. However there are not many surgeons who dare to say what they see, not what they wish to see. I have tried the most popular maneuvers to stabilize the elevated breast, but no matter what we do, late results do not differ much. There are numerous fixating tricks, like dermal strips, mesh of Sampaio Goes, internal bras etc.
Materials / method: The goal of mastopexy is to remove this skin-on-skin appearance by elevating the breast tissue. This way we also remove the support from the chest wall. Obviously, elevated shape cannot be maintained and the breast will hang over the inframammary sulcus. So, lifted breast is unstable, while ptotic breast is stable, because the opposite forces that cause ptosis and resist ptosis are equal. This is the equation of stability. What we aim at mastopexy is to provide an intrinsic support to the unstable elevated breast.
Results: As the breast heals after surgery, it resumes its genetically determined physical properties. And, due to the equation of stability, it has to resume the preoperative projection. That means that parenchymal modifications do not matter.
Conclusion: As soon as it is clear that the parenchymal flaps are nothing but vanity, my surgery became much easier. I need no hypercorrection. At the end of surgery the breast is close to its ultimate shape.
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