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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Fascial suspension mastopexy
Morris Ritz1, Ram Silfen, Graeme Southwick
1Melbourne Institute of Plastic Surgery, Department of Anatomy and Cell Biology, Monash University, Malvern, Victoria, Australia.
Background:
The objective of this study was to assess a new procedure for breast mastopexy, fascial suspension mastopexy.
Methods:
Between December of 2001 and July of 2004, 52 patients (102 breasts) underwent fascial suspension mastopexy. Sixteen women had grade 1 ptosis (30 percent), 31 had grade 2 ptosis (60 percent), two had grade 3 ptosis (4 percent), two (4 percent) had breast asymmetry and underwent unilateral mastopexy, and one had pseudoptosis (2 percent). Of the 52 patients, 43 (83 percent) underwent fascial suspension mastopexy only, whereas nine patients (17 percent) underwent fascial suspension mastopexy combined with breast parenchymal excision of less than 120 g in each breast. Three patients (6 percent) underwent combined procedures.
Results:
The complication rate was 7.7 percent (four patients). Two patients underwent conversion of the vertical scar into a horizontal scar. One patient underwent drainage of a hematoma 1 day after her operation, and one patient developed a hypertrophic scar. The average follow-up was 1.4 years, with the longest follow-up being 3.5 years. On a scale of 1 (very poor) to 10 (excellent), postoperative ptosis correction was rated as 8.8, breast symmetry as 8.4, postoperative upper pole fullness as 9.1, postoperative medial breast fullness as 7.8, and overall breast shape and contour as 8.6.
Conclusions:
Fascial suspension mastopexy is safe, simple, and versatile; does not require pectoralis major flap harvesting; and achieves an excellent suspension of breast parenchyma, creating a projected and rejuvenated breast shape with upper pole fullness and long-standing breast contour.