Augmentation Mastopexy Using a Submuscular Inferior Pectoralis Muscle Sling: An Outcome Analysis of Breast Animation...

Submuscular augmentation mastopexy (AM) is often recommended to improve stability and reduce implant visibility despite the risk of breast animation. Objective systems to measure this outcome are restricted by a lack of quantitative data.

This analysis of animation investigates factors that influence outcomes of this procedure using the inferior pectoralis muscle flap technique.

Quantitative data on breast animation, nipple (ND) displacement and inframammary fold (IMFD) displacement, nipple displacement angle, and lower pole contour distortion with the pectoralis muscle both relaxed and contracted were collected after AM with pectoralis muscle flap; animation was clinically assessed using a 4-point scale.

134 patients (268 breasts) with a mean follow-up of 28.5 months (range, 6-72 months) were analyzed:60 patients underwent primary procedures. Mean values for ND and IMFD fold were 1.51cm (range:0.35-3.72cm) and 1.49cm (0.35-2.99cm), respectively. Patients undergoing secondary surgeries exhibited higher values for ND (1.98cm; 0.48-3.72cm, p<0.001) and IMFD (1.94 cm; 0.58-2.99cm, p=0.8) and more frequent grade II (p=0.027) and III (p=0.012) lower pole contour deformities than those subjected to primary procedures. Multivariate analysis found age>30 years (p<0.001) and BMI>18 (p<0.001) to be significantly associated with ND. Twelve patients (8.7%) underwent revision surgery; animation deformities (2.9%) and capsular contracture (2.2%) were the most frequent reasons for reoperation.

This study offers the first quantitative evaluation of animation deformities in AM patients and describes an objective method that provides data on muscular dynamics and breast distortion. Our experience shows that pectoralis muscle flap technique may successfully prevent and treat ptosis and implant malposition, but patients undergoing secondary AM have a higher risk of animation.

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