摘要

Objectives: The aim of mastopexy is to remodel the breast but in most of the cases breast volume should be also reduced. Combing mastopexy with superior pedicle for nipple vascularization and inferior pedicle for autoaugmentation also with lipofilling offer to patients stable results without the use of an implant. We describe our experience with breast reshaping with composite mammaplasty wiht differrent skin resection patterns(J mammaplasty, wise pattern or circumvertical), only skin excision and autologous fat grafting. Materials / method: We describe the surgical technique for composite mammaplasty. Photographic documentation was done for every patients. Preoperative bleeding protocol included 1g of tranexamic acid. Postoperative all patients were discharged with kynesiotape to promote wound heeling without tension. Autologus fat grafting was performed under ultrasound control. Postoperative all patients had follow ups at 1,3, respectively 6 months after the surgery with one year ultrasound evaluation. Results: Fifty patients were included with one year follow up. Mean age of 38 years. All patients had follow up one year after surgery with ultrasound to evaluate fat grafting and gland position after autoaugmentation. Mean skin resection per breast was 15g. Mean autologous fat grafting was 95cc per breast. Superior and medial pedicle was performed in every case. Two cases required free nipple graft. Mean liposuction of the bra roll with radiofrequency assisted liposuction volume was 200cc(100-400cc) with 30 KiloJoules. Two patients had minimal superficial areola necrosis treated conservatively. One p Conclusion: Combining glandular reshaping , lipofilling and radiofrequency assisted liposuction stable results for postpartum patients may be obtained with high grade of satisfaction among patients and minimal complications.