Mastopexy Autoaugmentation by Using Vertical and Triangular Flaps of Mammary Parenchyma Through a Vertical Ice Cream Cone-Shaped Approach

Abstract

Background: Mastopexy autoaugmentation by using an extended vertical flap and two transverse triangular flaps of mammary parenchyma was performed through an adjustable vertical ice cream cone-shaped approach.

Method: A vertical rectangular flap with the length of the inferior pole and thickness of the mammary parenchyma was supported at the inframammary fold. Dissection of the vertical flap was extended underneath the areola until the projection of its upper limit, adding 4-5 cm to the length of the vertical flap. A triangular flap supported on its lower half with 4-6 cm long and thickness of the vertical pillar was dissected on both vertical pillars. Patients were followed up for 2 years.

Results: The vertical rectangular flap filled the upper pole and central breast. The triangular flaps apart from filling the lower pole increased the mammary cone projection. The medial rotation advancement of the triangular flaps created a transverse support girdle at the lower pole, maintaining the vertical flap into position. In addition, fixation of the vertical flap along its entire length avoided long-term down-displacement of the breast. A keel resection of mammary parenchyma was performed in the larger breast in mild or moderate asymmetries.

Conclusion: Mastopexy autoaugmentation through an adjustable vertical approach using vertical and triangular flaps of mammary parenchyma filled the upper pole and central breast and reshape the lower pole, recovering the breast contour. It provided long-term stabilization of the mammary cone without a breast implant or fat transfer.

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Keywords: Mammary parenchyma; Mastopexy autoaugmentation; Transverse girdle; Triangular flap; Vertical ice cream cone-shaped approach; Vertical rectangular flap.