Mastoplasty after Massive Weight Loss: Redefinition and Stabilization of the Breast Mound with Submuscular Autoprosthesis

CONTEXT: After massive weight loss, breast changes dramatically becoming ptotic, flat in the upper pole, with significant skin excess. After mastoplasty, often ptosis can recur and the upper pole can lose its fullness again. The technique described in this study treats breast deformities ensuring stable results and avoiding ptosis recurrence. AIM: To analyze a new modality of breast reshaping after massive weight loss, evaluating outcomes and complications as well as patient satisfaction. SETTINGS AND DESIGN: This was a case series. MATERIALS AND METHODS: Fifteen patients (all women, average age, 43.1 years) with bilateral breast ptosis after massive weight loss underwent mastoplasty: the technique included the creation of an inferior pedicle flap that was placed as a prosthesis under the pectoralis muscle and a superomedial pedicle flap containing the nipple–areola complex (NAC). Patients were followed up for at least 6 months, reporting any complications, and measuring the jugulum–NAC distance. Patients’ satisfaction was also reported. STATISTICAL ANALYSIS USED: Nil. RESULTS: All patients were extremely satisfied with the breast volume, shape, symmetry, and ptosis correction. The new mammary contour and the distance between the jugular fossa and the nipple were stable during the follow-up and the upper pole maintained its fullness. No major complications were reported. CONCLUSION: Mastoplasty with submuscular autoprosthesis proved to be a safe and effective technique to treat breast deformities after massive weight loss because removed redundant tissue repositioned the NAC and filled the upper pole with stable results over time. A similar technique has not been described yet.