Augmentation Mastopexy-Antigravity Flap Technique.

[BACKGROUND] This study aim to evaluate the effectiveness of an augmentation mastopexy technique utilizing an inferior-medial dermoglandular flap rotated and fixed to the lateral fascia of the pectoralis major muscle, along with the serratus muscle, to counteract the effect of gravity on the implant. The objective was to achieve satisfactory results with reduced recurrent ptosis and improved breast shape and projection.

[MATERIAL AND METHODS] A retrospective study involving 472 patients who underwent mastopexy augmentation between 2011 and 2020 was conducted. Inclusion criteria were age between 20 and 70 years old, with varying degrees of ptosis and moderate to severe skin sagging. The surgical technique used the inferior-medial dermoglandular flap, with specific variations based on breast characteristics. Follow-up evaluations were performed at one month, six months, and one year post-surgery.

[RESULTS] The antigravity dermoglandular flap technique resulted in a combined complication rate of 12.28%. Recurrent ptosis was observed in 4.44% of cases, with most cases requiring additional surgical intervention. The upper pole projection was satisfactory in 76.3% of cases, with some requiring revision for pseudoptosis. Breast symmetry improved progressively in 66% of cases over time. Areolar viability complications occurred in 3.17% of cases, and scar quality issues were noted in 3.60% of patients. Implant displacement occurred in 0.42% of cases, and capsular contracture was observed in 0.42% of patients.

[CONCLUSIONS] The antigravity dermoglandular flap technique is a reproducible procedure that effectively counteracts the force of gravity, achieving aesthetically pleasing results in augmentation mastopexy. However, close monitoring and surgical intervention might be necessary for specific complications such as recurrent ptosis and pseudoptosis, to achieve optimal outcomes.

[LEVEL OF EVIDENCE II] 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 .