Abstract
Background
After massive weight loss, one of the stigmas that afflict women is the remaining deformity of the breasts which become flaccid and ptotic, with an absent or flat upper pole. The authors propose the use of a well-established mammaplasty technique to fill the upper pole, reshape the breast cone, and correct ptosis with nipple–areola complex (NAC) repositioning.
Methods
A total of 16 patients were analyzed; all underwent gastroplasty between 18 and 24 months prior to mammaplasty. The mean age was 41.6 years (range = 26–62) and the mean BMI previous to the mammaplasty was 29.2 kg/m2 (range = 24.9–38.9). The technique included a dermo-lipo glandular flap pedicled on the inframammary fold (IMF) together with a superior flap containing the NAC.
Results
All patients who underwent surgery were satisfied with the outcomes since a more aesthetic breast shape was achieved, with projection of the upper pole and correction of ptosis. Adverse events included dehiscence at the junction point of the flaps in the inframammary fold, which resolved with secondary-intention wound healing in three patients; partial necrosis of the areola in one patient; epidermolysis in one of the NACs in one patient; and infection in one of the breasts in one patient, which resolved with proper antibiotic therapy.
Conclusion
When compared to the current mammaplasty techniques performed in formerly obese patients, this is a good surgical option because it uses tissues adjacent to the breast itself and does not require silicone prosthesis for breast augmentation. The patients reported increased self-esteem and improvement in their quality of life.
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-010-9516-8/MediaObjects/266_2010_9516_Fig1_HTML.gif)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-010-9516-8/MediaObjects/266_2010_9516_Fig2_HTML.gif)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-010-9516-8/MediaObjects/266_2010_9516_Fig3_HTML.gif)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-010-9516-8/MediaObjects/266_2010_9516_Fig4_HTML.gif)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-010-9516-8/MediaObjects/266_2010_9516_Fig5_HTML.gif)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-010-9516-8/MediaObjects/266_2010_9516_Fig6_HTML.gif)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-010-9516-8/MediaObjects/266_2010_9516_Fig7_HTML.jpg)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-010-9516-8/MediaObjects/266_2010_9516_Fig8_HTML.jpg)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-010-9516-8/MediaObjects/266_2010_9516_Fig9_HTML.jpg)
Similar content being viewed by others
References
Orpheu SC (2009) Estudo histomorfométrico comparativo do colágeno e elastina na pele abdominal humana após perda ponderal maciça. [Tese de Mestrado]. Faculdade de Medicina, Universidade de São Paulo, São Paulo, p 87. Available at: http://www.teses.usp.br
Song AY, Jean DR, Hurwitz DJ, Fernstein MH, Scott JÁ, Rubin JP (2005) A classification of contour deformities after bariatric weight loss: the Pittsburgh Rating Scale. Plast Reconstr Surg 116(5):1535–1544
Pitanguy I (1967) Surgical treatment of breast hypertrophy. Br J Plast Surg 20:78–82
Ribeiro L, Accorsi A, Buss A, Marçal-Pessoa M (2002) Creation and evolution of 30 years of the inferior pedicle in reduction mammaplasties. Plast Reconstr Surg 110(3):960–970
Wise RJ (1956) Preliminary report on a method of planning the mammaplasty. Plast Reconstr Surg 17(5):367–375
Hurwitz DJ, Agha-Mohammadi S (2006) Postbariatric surgery breast resha**: the spiral flap. Ann Plast Surg 56(5):481–486
Rubin JP, Khachi G (2008) Mastopexy after massive weight loss: dermal suspension and selective auto-augmentation. Clin Plast Surg 35(1):123–129
Losken A, Holtz DJ (2007) Versatility of superomedial pedicle in managing the massive weight loss breast: the rotation-advancement technique. Plast Reconstr Surg 120(4):1060–1068
Silveira Neto E (1976) Mastoplastia setorial com pediculo areolar interno. Anais do XIIIth Congresso Brasileiro de Cirurgia Plástica, Porto Alegre, November 1976, p 13
Graf R, Biggs TM (2002) In search of better shape in mastopexy and reduction mammaplasty. Plast Reconstr Surg 110(1):309–317
Cintra W Jr, Modolin ML, Gemperli R, Gobbi CI, Faintuch J, Ferreira MC (2008) Quality of life after abdominoplasty in women after bariatric surgery. Obes Surg 18:728–732
Ferreira MC (2000) Evaluation of results in aesthetic plastic surgery: preliminary observations on mammaplasty. Plast Reconstr Surg 106(7):1630–1635
Jurado J (1979) The vertical dermal-glandular flap of the inferior single pedicle in breast surgery. Transactions of the VIIth international congress of plastic reconstructive surgery, Rio de Janeiro, 1979, p 557
Mckissock PK (1972) Reduction mammaplasty with vertical dermal flap. Plast Reconstr Surg 49(3):245–252
Ribeiro L, Rocha RB (2008) Intercorrência em mamoplastia redutora. In: Resen JH (ed) Tratado de Cirurgia Plástica na Obesidade. Ed. Rubio, Rio de Janeiro, pp 381–394
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Modolin, M., Cintra, W., Silva, M.M. et al. Mammaplasty with Inferior Pedicle Flap After Massive Weight Loss. Aesth Plast Surg 34, 596–602 (2010). https://doi.org/10.1007/s00266-010-9516-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00266-010-9516-8