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Subpectoral Breast Fixation with Dermoglandular Inferior Pedicle: The "Dual Plane Autoprosthesis Technique"
1Department of Plastic and Reconstructive Surgery, Biruni University, Bagdat caddesi, Kantarci Riza Sk. No:1, 34728, Kadikoy, Istanbul, Turkey. uutzereyak@yahoo.com.
Background:
This study introduces a modification of the traditional inferior pedicle technique using a mono dermoglandular suspension flap placed beneath the pectoralis major muscle. The technique aims to preserve breast contour, prevent lower pole sagging, and enhance upper pole fullness.
Methods:
A retrospective analysis was conducted on 47 patients (12 reduction mammoplasties and 35 mastopexies) who underwent surgery using the modified inferior pedicle with inverted-T scar technique between March 2018 and February 2023. The surgical method involved preparation of a dermoglandular flap derived from the distal portion of the classical inferior pedicle (d-MIP), which was positioned in the subpectoral plane to provide suspension and volume enhancement. The technique is described in detail, including flap planning, skin dissection, parenchymal resection, breast reshaping, repositioning of the nipple-areola complex, and skin envelope closure. Upper pole fullness was evaluated preoperatively and 12 months postoperatively using linear-probe ultrasonography (USG, 4-13 MHz). Patient satisfaction was assessed using the BREAST-Q questionnaire.
Results:
The BREAST-Q scores revealed a mean breast satisfaction score of 84.19 and an outcome satisfaction score of 91.67. Ultrasonographic measurements showed a statistically significant difference (t-test, p = 0.005).
Conclusion:
The dual-plane autoprosthesis technique, involving subpectoral placement of a mono dermoglandular inferior pedicle flap, provides a reliable solution for recurrent ptosis and upper pole volume loss in breast surgery. By preserving projection, this method ensures long-term esthetic outcomes and minimizes complications associated with traditional techniques.
Level Of Evidence Iv:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .