Mohammed Saad AboShaban1, Mahmoud Ahmed Abdelaty2. 1. Plastic and Reconstructive Surgery Department, Faculty of Medicine, Menoufia University, Yassein Abdelafar Street, Shebin Elkom, Egypt. dr.mohamed.aboshaban@med.menofia.edu.eg. 2. Plastic and Reconstructive Surgery Department, Ahmed Maher Teaching Hospitals, Cairo, Egypt.
Abstract
BACKGROUND: Revision augmentation-mastopexy is a complex procedure that aims to correct the complications of a previous surgery. The purpose of this study was to evaluate the reliability of the inferior-based dermoglandular flap with partial subpectoral implant coverage to correct implant- and tissue-related complications associated with primary subglandular breast augmentation and its influence on improving outcomes. METHODS: This was a retrospective study in which a total of 53 patients (106 breasts) underwent revision augmentation-mastopexy using the double coverage technique for an implant with an inferior-based dermoglandular flap and superior-based pectoralis major muscle (biplane) as the first layer and a nipple-areolar flap with breast pillars as the second layer. This technique provides a suspensory reconstruction that acts as hammock to minimize the pressure on the inframammary fold and maintain position integrity. RESULTS: The follow-up period ranged from 2.3 to 4 years (mean 3.6 years), and the recorded complications were minor wound dehiscence less than 1 cm2 at the "T" junction in three breasts (2.83 %) and mild hypertrophic scarring in five breasts (4.72%). CONCLUSION: The use of an inferior-based dermoglandular flap with partial subpectoral biplane implant reinforcement allows autologous support and double coverage to decrease the incidence of implant- and tissue-related complications, especially pseudoptosis, lower pole widening, capsular contracture, rippling, and implant visibility. It achieves enhanced upper pole fullness, medial cleavage, projection, and breast volume. 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 .
BACKGROUND: Revision augmentation-mastopexy is a complex procedure that aims to correct the complications of a previous surgery. The purpose of this study was to evaluate the reliability of the inferior-based dermoglandular flap with partial subpectoral implant coverage to correct implant- and tissue-related complications associated with primary subglandular breast augmentation and its influence on improving outcomes. METHODS: This was a retrospective study in which a total of 53 patients (106 breasts) underwent revision augmentation-mastopexy using the double coverage technique for an implant with an inferior-based dermoglandular flap and superior-based pectoralis major muscle (biplane) as the first layer and a nipple-areolar flap with breast pillars as the second layer. This technique provides a suspensory reconstruction that acts as hammock to minimize the pressure on the inframammary fold and maintain position integrity. RESULTS: The follow-up period ranged from 2.3 to 4 years (mean 3.6 years), and the recorded complications were minor wound dehiscence less than 1 cm2 at the "T" junction in three breasts (2.83 %) and mild hypertrophic scarring in five breasts (4.72%). CONCLUSION: The use of an inferior-based dermoglandular flap with partial subpectoral biplane implant reinforcement allows autologous support and double coverage to decrease the incidence of implant- and tissue-related complications, especially pseudoptosis, lower pole widening, capsular contracture, rippling, and implant visibility. It achieves enhanced upper pole fullness, medial cleavage, projection, and breast volume. 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 .
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