The Versatility of the Lateral-based Mammary Flap as an "Auto-implant" for Enhancing Breast Mound for Patients Undergoing Primary Mastopexy.

ABSTRACT

Background: The demand for augmentation-mastopexy surgery without using implants has significantly increased over the years. Fat transfer offers an alternative method, but some patients do not favor this procedure either. The purpose of this study was to evaluate the versatility of using a lateral-based mammary flap as an "auto-implant" for enhancing the breast mound for patients undergoing primary mastopexy. Method: This retrospective study was performed between February 2016 and April 2019, including 36 female patients (72 breasts). Our technique involves using the inferior breast tissue by elevating the lateral-based dermoglandular flap that was moved cranially with a 90 degree rotation in a conical shape within the created pocket to refill the superior and central mound. Result: The mean nipple projection was 11.2 after 36 months postoperative compared with 5.2 before surgery. The mean ± SD of pre- and postoperative measurements for the lower pole zone were 80.2 ± 10.5 and 50.1 ± 6.4, and those for the upper pole zone were 40.3 ± 9.5 and 63.9 ± 6.5, respectively. The distance of breast mound elevation after the surgical procedure ranged from 5.30 to 9.55 cm, with a mean of 7.90 cm. Conclusions: The lateral-based mammary flap acts like an implant that helps shape and augment the breast, enhances the mammary projection, and restores the breast contour without requiring a synthetic implant or fat grafting. It is a reliable technique with high patient satisfaction but is unsuitable for patients with insufficient breast volume.