Meeting today's demands: a central-pedicle mastopexy technique with inner corium support
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: In the the preoperative markings, the inframammary fold height predicted the new mamilla position. Willing to accept an inverted-T scar, excess skin and if desired up to 250g of breast tissue were resected in the lower pole while creating two lateral dermis flaps. The mamilla atop a central pedicle was dissected from the surrounding skin and the two flaps were overlappingly fixated to rib periost underneath the elevated pedicle, thus prompting a subcutaneous support structure. The new mamilla position was defined, the mamilla sutured into place and all remaining wounds closed.
Results: In 47 cases since 2020 we conducted postoperative consultations 1, 2 and 6 weeks after the surgery with follow-ups 3, 6 and 12 months postoperatively. The following aspects were noted: pain, issues in wound healing or mamilla perfusion, changes in nipple sensitivity and overall patient satisfaction. No pain levels above 6/10 were noted, 5 cases of delayed wound healing not requiring additional surgery occurred as well as 4 cases of decreased nipple sensitivity for no longer than 6 months. Over 45 patients saw their expectations met, would undergo it again and would recommend it to others.
Conclusion: Our 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 managing 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.
