Explantation Mastopexy Using Long Superior Dermoglandular Flap: A Retrospective Analysis of our Technique.

[BACKGROUND] The 2021 ISAPS global survey shows a 49.6% rise in demand for breast implant explantation from 2017. The current challenge is to formulate a standardized technique of mastopexy after explantation, which counters the volume deficit and skin redundancy post removal of implant, giving aesthetically pleasing breast. In this paper, we describe the technique of explantation mastopexy based on superiorly based infra-areolar dermoglandular flap and retrospectively analyse the data for past 3 years.

[METHODS] After Institutional review approval, a retrospective analysis of data extracted for breast explantation and mastopexy using the author's technique was done from 1st June 2021 to 31st August 2023. The surgery was performed by the principal author in a single centre. A post-operative Breast-Q questionnaire after 2 weeks for outcome analysis was sent through email.

[RESULTS] A total of 150 patients were operated during study time period with mean age of 47.85 ± 9.71years. The reasons for explantation included patient no longer feeling the need for breast implant (66%), breast implant-associated illness (27.33%), implant rupture (4.66%) and capsular contracture (2%). Explanation surgery was seen after mean duration of 14.70 ± 5.68 years after breast augmentation. The post-operative outcome was uneventful for 141 cases (94%). On analysis of questionnaire, 67.8 was mean score for satisfaction with breasts and 56.4 for satisfaction with outcome of surgery for the 100 responses received.

[DISCUSSION] The surgical technique here uses a superiorly based infra-areolar dermoglandular flap which uses own inferior breast tissue to provide upper and medial pole fullness by tacking to pectoral fascia providing a sturdy anchor. The use of inferior breast tissue to augment the central mound shifts up the inframammary crease. The study also objectively evaluates outcome using Breast-Q questionnaire analysis but lacks comparison with other techniques.

[CONCLUSION] Superiorly based infra-areolar dermoglandular flap with folding and tacking to pectoral fascia is a safe technique to manage post breast implant explantation volume deflation.

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