Mastopexy after massive weight loss: dermal suspension and total parenchymal reshaping

Building on the work of others who have advocated securing breast tissue to adjacent structures to achieve better projection, the author presents a technique that eliminates the lateral axillary roll deformity while using this tissue to augment breast volume-a particular advantage in the patient with massive weight loss. The procedure, although requiring a longer operating time and resulting in a significant scar, produces a pleasing breast contour, is safe and reliable, and has a low complication rate.