Mammoplasty: breast fixation with dermoglandular mono upper pedicle flap under the pectoralis muscle.

A surgical procedure for breast fixation to avoid secondary ptosis of the lower quadrants and nipple-areola complex bascule and to maintain the breast upper pole projection is described and evaluated after long-term pexy and reduction mammoplasty. A superior monopedicle dermal-adipose-glandular flap with the areola-nipple complex placed in its base is mobilized and its extremity sutured to a "trapdoor" type of flap dissected in the pectoralis muscle. This procedure determines the permanent areola-nipple complex and the upper breast quadrant position, avoiding the common secondary breast ptosis, when the breast tissue is sutured to the pectoralis muscle. One thousand seven hundred patients have undergone this procedure in the last 15 years.