Multiplanar Assembly Mammaplasty Based on the Divine Proportion

BACKGROUND: The study sought to plan mastopexy and breast reduction according to the principle of the divine proportion, represented by the letter phi, via the convergent assembly of multiple layers to create the new breast. This strategy is based on the constancy of the submammary fold and the orientation of the vertex of a V-shaped triangle opening at approximately 60° at the umbilicus, with each branch opening in the direction of the acromioclavicular joint. METHODS: The strategy was prospectively investigated in 265 patients (n = 530 breasts). The mean patient age was 36 years. The follow-up ranged from 6 months to 3 years. RESULTS: A total of 220 patients (83%) received a good score (1–4) according to Strasser grading. Complications were few, but included delayed healing with minimal scar ulceration in 19 patients (7%), asymmetry in 16 (6%), and partial nipple necrosis in 4 (1.5%). CONCLUSIONS: This approach adds precision to mammaplasty, reduces the laxity in the axillary region, promotes bulk in the upper pole, and eases nipple–areola complex elevation.