Patrick Mallucci1, Giovanni Bistoni2. 1. Plastic surgery in private practice, London, UK. 2. Sapienza University of Rome, Department of Surgery, Plastic and Reconstructive Surgery Unit, Rome, Italy.
Abstract
BACKGROUND: The use of mesh in the breast has gone in and out of fashion over the years. It is well described and yet there has been poor uptake of its use in aesthetic breast surgery. P4HB (GalaFlex, Galatea, Lexington, MA) has recently been described as a useful adjunct in supporting poor tissue quality with positive early outcomes and low complication rates. OBJECTIVES: To determine the outcome and range of indications of PH4B in aesthetic breast surgery, in particular to document its effectiveness in assisting with long term outcomes in mastopexy. METHODS: Firstly, an observational study was undertaken standardizing mastopexy techniques with P4HB included as part of the procedure. Photographic measurements were taken to determine the extent of both lower pole descent and lower pole stretch at 3 months and 1 year post op in order to observe change over time. Secondly, a series of other indications were explored including the correction of secondary defects such as inferior malposition and symmastia. RESULTS: The results of the mastopexy study were highly encouraging and comparable to those previously published in the literature, confirming sustained stability of the lower pole over time for both mastopexies and implant mastopexies. In addition, the GalaFlex was successfully used in the correction of many secondary defects. CONCLUSIONS: P4HB is extremely versatile, easy to use and with very low complication rates. The results have led to a change in practice with routine incorporation of GalaFlex for all routine mastopexies. It has also replaced the use of acellular dermal matrices in aesthetic breast surgery.
BACKGROUND: The use of mesh in the breast has gone in and out of fashion over the years. It is well described and yet there has been poor uptake of its use in aesthetic breast surgery. P4HB (GalaFlex, Galatea, Lexington, MA) has recently been described as a useful adjunct in supporting poor tissue quality with positive early outcomes and low complication rates. OBJECTIVES: To determine the outcome and range of indications of PH4B in aesthetic breast surgery, in particular to document its effectiveness in assisting with long term outcomes in mastopexy. METHODS: Firstly, an observational study was undertaken standardizing mastopexy techniques with P4HB included as part of the procedure. Photographic measurements were taken to determine the extent of both lower pole descent and lower pole stretch at 3 months and 1 year post op in order to observe change over time. Secondly, a series of other indications were explored including the correction of secondary defects such as inferior malposition and symmastia. RESULTS: The results of the mastopexy study were highly encouraging and comparable to those previously published in the literature, confirming sustained stability of the lower pole over time for both mastopexies and implant mastopexies. In addition, the GalaFlex was successfully used in the correction of many secondary defects. CONCLUSIONS: P4HB is extremely versatile, easy to use and with very low complication rates. The results have led to a change in practice with routine incorporation of GalaFlex for all routine mastopexies. It has also replaced the use of acellular dermal matrices in aesthetic breast surgery.