Objectives: The Author provides some elements of the technique used for mastopexys. This technique is quite versatile and can be applied to all cases of breast ptosis when a volume increase is not necessary.
Introduction: The correction of mammary ptosis with mastopexy consists in repositioning of the glandular parenchyma and restoring the cone of the breast, optimizing the shape. In cases of marked ptosis with considerable discrepancy between skin/gland following severe breast involution or weight-loss, a valid surgical strategy is to correct the ptosis with mastopexy and to integrate the volume using breast implants , whose shape varies according to the specific case.
However, this choice may not be feasible due to the patient's psychological habit, when there is a refusal to use the prosthesis.
Materials / method: Mastopexys was performed by using dr. Millan’technique, an “à la demand “ procedure, which basically consist in : Undermining the gland from the prepectoral fascia and skin/gland dissection of a part of the inferior pole, vertical division of the gland in two flaps , reconstruction of the glandular cone, skin redraping and excision of excess skin, repositioning of the NAC.
Results: The detachment and the subsequent repositioning of the gland in a higher position on the pectoral muscle, together with the possibility of using the glandular flaps in the best way to reconstitute a more harmonious breast cone, represent a guarantee of stability of the result over time. In fact, the advantage of this technique is to achieve a valid correction of mammary ptosis with good results that last long.
Conclusion: In mild breast ptosis, simple augmentation mastoplasty can be considered without exceeding in volume implant.
In ptotic breast with severe hypomastia and marked excess skin my first choice is mastopexy and implants (subglandular or subpectoral pocket) which increase volume and firmness of the gland, achieving a good upper pole projection and shorter scars.
When implants can not be considered, mastopexy with autologous flap repositioning is a good surgical option.
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