Myoglandular Slide-Up Mastopexy with Winged Flap Autoaugmentation: A Useful Method in Low-Set Breasts.

[BACKGROUND] It is difficult to change the shape and location of the breast footprint in nonimplant mastopexies of low-set breasts. The authors use a combined technique to solve these 2 problems. Autoaugmentation with retromammary flap is an effective method to change the shape of the breast footprint. The authors increase the breast projection with a winged modification of the retromammary flap and slide up the breast mound as a myoglandular flap by pectoralis muscle division.

[METHODS] Thirty-two patients with low-set breasts underwent this combined nonimplant mastopexy technique. Preoperative and postoperative patient evaluations included physical and radiologic examinations, breast measurements, and BREAST-Q surveys. The surgical procedure involved forming a new and projected breast cone with a winged inferior flap and sliding the breast footprint upward on the chest wall. Postoperative breast measurements, radiologic examinations, and BREAST-Q surveys were recorded at least 6 months after surgery.

[RESULTS] A total of 29 patients had a postoperative follow-up longer than 6 months. Comparison of preoperative and postoperative measurements showed significant changes in all measurements of breast shape and footprint positions. The vertical height of the breast footprints increased and the horizontal lengths decreased and also the inframammary folds of both breasts moved upward significantly ( P < 0.001). BREAST-Q scores showed significant improvement in the postoperative period.

[CONCLUSION] The combined retromammary winged flap and myoglandular flap technique effectively improves breast aesthetics in low-set breasts by increasing breast projection and changing the shape and position of the footprints without using implants.

[CLINICAL QUESTION/LEVEL OF EVIDENCE] Therapeutic, IV.