Resumo

Objectives: With an increasing demand for mastopexy surgery in patients under 50 years of age, we were seeking a safe and reliable mastopexy technique that provides long lasting results. Introduction: Candidates wishing to regain a firm yet natural breast shape without the need for breast implants prompted us to rethink our approach. The new technique was to meet the following requirements: limited downtime, minimal risk for loss of perfusion or sensitivity in the mamilla, no need for breast implants or other foreign grafts, enduring youthful shape of the breast. Materials / method: We projected an inverted T scar. The inframammary fold height predicting the new mamilla position. Excess skin and if desired up to 250g of breast tissue were resected in the lower pole. Two lateral dermis flaps were hereby left for later supporting the reshaped tissue. The mamilla atop a central pedicle was dissected from the surrounding skin. The central pedicle was moved cranially with the two dermis flaps overlappingly fixated to rib periost underneath. The new mamilla position defined in upright torso position, the mamilla was sutured into place and all remaining wounds closed. Results: In 108 cases since 2020 we conducted postoperative consultations. The following aspects were noted: pain, issues in wound healing, issues in perfusion of the mamilla, changes in nipple sensitivity and overall patient satisfaction. No pain levels above 6 /10, 7 cases of delayed wound healing (none requiring additional surgery),1 case of temp. perfusion issues, 4 cases of temp. decreased nipple sensitivity, 1 case of heightened nipple sensitivity. 103 saw their expectations met, 104 would have the same procedure again and 106 would recommend the procedure to others. Conclusion: Our refined technique of a central-pedicle mastopexy with inner corium support provides steady and reproducible results in patients wanting to regain a youthful appearance of their breast without the desire for augmentation or wanting to avoid the implantation of foreign bodies. With most mastopexy patients today having the surgery while wanting to manage a busy work and leisure schedule, this technique of mastopexy demands little downtime and need for extended wound care while providing subjectively appealing results no later that six weeks after the surgery.