Inverted-T Mastopexy With Glandular Treatment and Breast Augmentation: Outcomes and Stabilization Approach

Long-term stability in mastopexy and augmentation-mastopexy remains challenging, particularly in patients with dense or ptotic glandular tissue, where skin-based reshaping alone may result in recurrent ptosis or contour distortion. We evaluated a glandular tissue-specific constraining element release technique designed to improve breast shape durability and nipple-areola complex (NAC) elevation. A multicenter retrospective analysis was performed in Venezuela, Mexico, and Peru, including 417 consecutive patients who underwent mastopexy or augmentation-mastopexy between January 2017 and December 2021. The technique consisted of selective release of glandular and aponeurotic restrictive elements while preserving key vascular pedicles, with implant placement when indicated. Outcomes assessed included NAC elevation, postoperative complications, and patient satisfaction at 1-year follow-up. Patients ranged from 17 to 64 years; 67.63% presented glandular hypertrophy with ptosis, and 32.37% had ptosis or hypotrophy. Mean NAC elevation was 7.5 cm (range, 5-9 cm). Complications included 3 cases of total NAC necrosis (all secondary procedures), 13 cases of partial NAC compromise, 10 hematomas, 11 partial wound dehiscences, 3 seromas, and 5 reoperations for shape-related issues. At 1 year, 78% of patients were very satisfied, 18% were satisfied, and 4% were dissatisfied. Selective glandular release with preservation of vascular pedicles provides reliable NAC elevation and stable breast shaping, with complication rates comparable to established techniques.