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Related Experiment Video

Updated: Jun 6, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
13:35

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction

Published on: May 17, 2024

"Upside-down" augmentation mastopexy.

Franco Migliori1

  • 1Plastic Surgery, San Martino University Hospital, Largo Rosanna Benzi 10, 16132 Genoa, GE, Italy. franco.migliori@fastwebnet.it

Aesthetic Plastic Surgery
|November 26, 2010
PubMed
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Attitudes of morbidly obese patients to weight loss and body image following bariatric surgery and body contouring.

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The upside-down breast surgery technique effectively corrects post-massive weight loss (MWL) breast deformities like ptosis. This method significantly reduces recurrence rates compared to other techniques, offering natural shape and stable positioning.

Area of Science:

  • Plastic Surgery
  • Aesthetic Surgery
  • Reconstructive Surgery

Background:

  • Massive weight loss (MWL) frequently results in breast hypotrophy and ptosis.
  • Existing techniques for postbariatric body contouring have limitations in addressing these specific breast deformities.
  • A need exists for a refined surgical technique to correct MWL-induced breast ptosis and hypotrophy.

Purpose of the Study:

  • To introduce and evaluate the "upside-down" surgical technique for correcting breast hypotrophy and ptosis in post-massive weight loss patients.
  • To assess the efficacy and recurrence rates of the upside-down technique compared to other surgical methods.

Main Methods:

  • The upside-down technique involves specific glandular undermining, retroglandular dissection, and implant insertion (dual-plane or retroglandular).

Related Experiment Videos

Last Updated: Jun 6, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
13:35

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction

Published on: May 17, 2024

  • Breast lifting is achieved through strong anchorage to fascial, muscular, and periosteal tissues.
  • Implant selection (round vs. anatomic) is based on the aesthetic defect and patient preference; periareolar suturing uses the interlocking technique.

    • Main Results:

    • 231 patients underwent bilateral surgery using the upside-down technique between 2001 and 2010.
    • The ptosis recurrence rate was 9.1% for the upside-down technique, significantly lower than 27.6% for other methods.
    • Mean operating time was 150 minutes, with a mean hospital stay of 3.5 days.

    Conclusions:

    • The upside-down technique offers natural shape, stable implant position, and short scars for post-MWL breast correction.
    • Last-generation dual-cohesiveness anatomic implants are recommended for optimal results, particularly for correcting breast flatness.
    • The technique demonstrated a 100% improvement in patient-reported discomfort (Body Uneasiness Test).