In women who present breast ptosis, that is, when in profile the nipple is located below the inframammary fold, a technique to raise the breast named mastopexy is indicated.
We remodel the breast glandular tissue to obtain shape a full, youthful and elevated breast. The main novelty of our method is that the shape and the weight of the breast are not borne by the skin, as is the case when classical techniques with inverted T scar are performed. In our technique, the weight is borne by the sutures which anchor the glandular structures conforming the newly shaped breast to the pectoralis muscle. Thus, scar widening is avoided and the breast remains in place.
We also use our technique for repositioning the nipple at the end of the operation. Applying our new technique, which we presented at the annual meeting of the American Society of Aesthetic Surgery and was described in the Aesthetic Surgery Journal, the design does not require the prior removal of the skin that will correspond to the final nipple location; rather, the position of the nipple-areolar complex is determined at the end of the procedure when the breast is already elevated. This makes it easier to achieve symmetry with the contralateral breast.
To do so, a triangular design is made prior to the operation. The vertex of the triangle is where the nipple will finally be located after completing the elevation. The aim of our technique is to place the areola in the correct position without any tension, performing the procedure symmetrically in both breasts, without being conditioned by the design and the skin removal required by the Lejour technique.
If the breast loses volume, a breast augmentation implant can be inserted during the mastopexy. If this is necessary, the most suitable implant size for the patient is selected using prosthesis sizers.
So our technique comprises the positioning of the nipple-areola complex after remodeling the breast and raising it to the correct position, suturing the glandular structures to the pectoralis muscle, and the insertion of a breast implant if needed. With this method we achieve long-lasting and highly satisfactory aesthetic outcomes.
We can also perform lipofilling and increase the breast using the patient's own fat. Sometimes, if the amount of fat available is sufficient, we perform lipofilling and do not use a prosthesis.
Sometimes, in addition to the insertion of the prosthesis, if the breasts are slightly apart, we create two half-moons with lipofilling to make the cleavage narrower.