Mammoplasty after massive weight loss
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Data
2014
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Resumo
Introduction: After massive weight loss, patients present with various
mammary changes, such as sagging, different grades of ptosis, and empty
upper pole. Different mammoplasty techniques are used to shape the
mammary cone and to reposition the nipple-areolar complex (NAC). In
this study, we evaluate how different surgical approaches can satisfy the
requirements of each patient. Method: Twenty-five patients who underwent
mammoplasty following gastroplasty were analyzed. The mammoplasty
techniques used were (1) mastopexy without implant with inferior flap; (2)
mastopexy without implant with inferior areolar pedicle; (3) mastopexy
with implant and coverage by inferior flap; (4) mastopexy with implant and
plication of cross flaps (jacket procedure). Results: The average body mass
index (BMI) before mammoplasty was 26.6 (ranging from 21.6 to 31.2). All
patients who underwent this surgery rated the outcome obtained as good or
great. In an evaluation carried out by an observer unaware of the techniques
employed, the results obtained were considered to be satisfactory for breast
shape, correction of breast ptosis, and filling of the upper pole. One patient
who underwent mastopexy with implants and cross flaps developed seroma
and subsequent capsular contracture, which required capsulectomy. Eight
patients developed unilateral dehiscence: seven at the junction of skin flap
in the inframammary fold, and one vertically, which were resolved with
healing by secondary intention. No cases of necrosis or NAC epitheliosis
were observed. Conclusion: Using different mammoplasty techniques, which
were personalized and analyzed on a case-by-case basis, good outcomes
and a high level of patient satisfaction were achieved. Various factors, such
as the furcula-papilla distance, the need to lift the NAC, pre-mammoplasty
breast volume and the patient’s desire to increase breast volume, influence
the choice of the surgical technique.
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Palavras-chave
Body contour, Massive weight loss, Mastopexy, Mamomplasty, Contorno corporal, Perda ponderal maciça, Mastopexia, Mamoplastia
Citação
ROSIQUE, Marina Junqueira Ferreira; ROSIQUE, Rodrigo Gouvêa . Mammoplasty after massive weight loss. Revista Brasileira de Cirurgia Plástica, São Paulo, v. 29, n. 3, p. 375-383, 2014.