Breast Codes: Triple-Plane Autologous Fat Grafting in Mastopexies and Reduction Mammaplasties without Implants

Several techniques for performing mastopexy and reduction mammaplasty have been reported; however, none has effectively maintained breast and upper pole projection. Silicone implants address these limitations but are associated with higher risks than nonimplant surgical procedures. Growing concerns include the risk of anaplastic large cell lymphoma and adjuvant-induced autoimmune syndrome. In addition, some women desire volume enhancement without implants. Autologous fat grafting is increasingly used for aesthetic breast augmentation and reconstruction. However, few studies have explored its combined use in muscle and breast planes during reduction mammaplasty and mastopexy. No study has yet standardized fat grafting across submuscular, intramuscular, and subcutaneous planes. This study is innovative in systematizing the fat grafting technique and standardizing its simultaneous application to the submuscular, intramuscular, and subcutaneous planes during mastopexy and reduction mammaplasty. It also identifies specific grafting zones for upper pole projection.