The Infero-Central Mound Reduction Mammoplasty: A Single Surgeon, 20-year Experience.

BACKGROUND: Reduction mammoplasty (RM) remains one of the most common plastic surgeries worldwide. Many different techniques have been described in the literature, each with its advantages and limitations. Nipple-areolar complex necrosis remains a daunting complication, regardless of the chosen surgical approach. OBJECTIVE: We describe the senior author's (HYK) unique reduction mammoplasty technique, employing the infero-central (IC) pedicle throughout the last two decades. PATIENTS AND METHODS: A retrospective chart review of 520 patients undergoing breast reduction was performed. After exclusion criteria, 360 were included in the study. These patients underwent RM with the IC technique, with stabilization of the breast mound and plication of the inferior pole dermis to prevent bottoming out. Demographics, operative data, and complications were recorded. Pre- and postoperative photographs were evaluated by a specialists' panel. The BREAST-Q questionnaire was utilized to assess satisfaction rates. RESULTS: BREAST-Q questionnaire-satisfaction with breast score was 84.19, and outcome score was 91.67. Aesthetic outcome evaluation, reviewed by four plastic surgeons, yielded a high score in all parameters (1.64-2; range 0-2). On a per-breast basis for all patients, the following complications were analyzed: dehiscence (3.61%), infection (2.22%), hematoma (1.66%), superficial wound healing problems (1.38%), seroma (0.83%), skin flap ischemia (1.52%), hypertrophic scar (1.38%), fat necrosis (0.97%), and partial nipple ischemia (0.27%). CONCLUSION: Infero-central mound technique can be applied to breast reductions of nearly all sizes, allowing for consistently satisfactory aesthetic outcomes for most patients. Due to robust vascularity of the pedicle, complication rates are kept at a minimum. IC mound technique is an essential tool in the plastic surgeon's armamentarium. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A single surgeon's experience with Motiva Ergonomix round SilkSurface silicone implants in breast reconstruction over a 5-year period.

BACKGROUND: Numerous breast implants are used for breast reconstruction. Each has its advantages and disadvantages. Recent data regarding the link between BIA-ALCL and implant texture caused a significant paradigm shift toward the use of smooth round implants. Motiva Ergonomix, a silk-surface breast implant, is classified as a smooth implant. To date, there is little data regarding the use of this specific implant in breast reconstruction. OBJECTIVE: Describe a single surgeon's experience with Motiva Ergonomix, silk-textured, round implant for breast reconstruction. PATIENTS AND METHODS: A retrospective chart review of all patients undergoing primary or revisionary breast reconstruction procedures, using Motiva Ergonomix, from January 2017 to January 2022. Patient demographics and medical status were extracted. Surgical data, including reconstructive technique, implant size, plane, use of acellular dermal matrix, and complications, were recorded. BREAST-Q questionnaires were completed. RESULTS: A total of 156 consecutive patients were retrieved (269 breasts). A total of 257 were direct-to-implant reconstructions and 12 expander-to-implant. Complications were described per breast. Capsular contraction, Baker grade 3-4, was seen in four breasts (1.49%) in the nonirradiated group and six (2.24%) in the irradiated group. Rippling was seen in 11 breast (4.08%), skin ischemia in 17 (6.31%), hematoma in 4 (1.49%), and seroma in 6 (2.23%). BREAST-Q: satisfaction with breast increased by a mean of 9.175 (60.7 points preoperatively to 69.875 postoperatively). Satisfaction with the implant was 6.52 out of 8. DISCUSSION: This cohort describes the current most extensive experience with Motiva Ergonomix implant used for reconstructive surgeries. Motiva Ergonomix breast implant endows a unique set of technologies to provide good results with a low complication rate.