A COMBINATION TECHNIQUE OF AUTOLOGOUS AUGMENTATION AND BREAST LIFTING IN HYPOPLASTIC-THIRD GRADE PTOTIC BREAST: A CASE REPORT
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Highlights:
- This case shows autoaugmented mastopexy as a natural alternative to silicone implants for patients seeking breast enhancement.
- The combination of breast lift and autoaugmentation using the patient’s own tissue is presented as an effective method for achieving a firmer breast appearance while maintaining a natural look.
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The use of tailored preoperative design, including breast ultrasound, enhances surgical safety and outcomes.
Abstract:
Introduction: Breast ptosis is a common concern among women due to factors such as aging, pregnancy, breastfeeding, and weight loss. To achieve a beautiful breast shape, mastopexy (breast lift) with augmentation is often required. This case report highlights the relevance of the chosen augmentation method in addressing ptosis.
Case Illustration: A 30-year-old woman had breast ptosis after her 2nd child and wanted a breast lift to have lifted and firmer breasts. Due to limited fat tissue available for transfer and her refusal to use silicone implants, the patient chose autoaugmented mastopexy. Before surgery in August 2022, breast ultrasound showed abnormalities. Preoperative design was made to determine skin and pedicle positions, using a wise pattern with a superior pedicle to lift the nipple-areola complex (NAC) and an inferior pedicle for autoaugmentation. Surgery was done carefully to achieve symmetry and desired result.
Discussion: Breast tissue changes a lot during and after pregnancy and hormonal factors increases the risk of ptosis. According to Regnault classification, the patient was classified as 3rd degree ptosis. While prosthetic implants are common in breast surgery, the patient declined that option. Autoaugmented mastopexy offers a more natural result without the risks of implants.
Conclusion: Breast lift with autoaugmentation is suitable for patients with breast ptosis seeking a firmer appearance without added volume. This technique utilizes the patient's own tissue to achieve satisfactory results, although outcomes may vary depending on individual factors.
Aso J, González I. Postpartum Breast Augmentation with Implants. Post-maternity Body Changes 2023; 297–320. DOI: 10.1007/978-3-030-43840-1_17
Spiegel AJ, Kania K, Hamilton KL. 2020 special issue: Twenty years of breast reconstruction: Past, present, and future. Breast J 2020; 26: 39–41. DOI: 10.1111/ tbj.13716
Suh DH, Jang HW, Lee SJ, et al. Outcomes of polydioxanone knotless thread lifting for facial rejuvenation. Dermatologic Surgery 2015; 41:720–725. DOI: 10.10 97/DSS.0000000000000368
Garg S, Bansal A, Marwah MK. Breast Augmentation: Cutaneous Aspects and Complications. Skin Diseases in Females 2022; 549–586. DOI: 10.1007/978-981-16-6065-8_26
Miseré RM, van Kuijk SM, Claassens EL, et al. Breast-related and body-related quality of life following autologous breast reconstruction is superior to implant-based breast reconstruction - A long-term follow-up study. The Breast 2021; 59: 176–182. DOI: 10.1016/j.brea st.2021.07.003
The Aesthetic Society. Aesthetic Plastic Surgery National Databank. 2022. Available at https://cdn.theaesthetic
society.org/media/statistics/2022-TheAestheticSocietyStatistics.pdf
Newman MK. Reconstruction of the ptotic breast using wise pattern skin deepithelialization. Plast Reconstr Surg Glob Open; 4. Epub ahead of print 2016. DOI: 10.1097/GOX.0000000000001077.
Costas T, Gomes-Ferreira M, Olivas-Menayo J. Mammary Tissue Changes During Pregnancy and Breastfeeding. Post-maternity Body Changes 2023; 247–261. DOI: 10.1007/978-3-030-43840-1_14
Huang NS, Quan CL, Mo M, et al. A prospective study of breast anthropomorphic measurements, volume and ptosis in 605 Asian patients with breast cancer or benign breast disease. PLoS One 2017; 12: e0172122. DOI: 10.1371/journal.pone.0172122
Kam, RL, Amir LH., and Cullinane, M. Is there an association between breast hypoplasia and breastfeeding outcomes? A systematic review. Breastfeeding Medicine,2021. 16(8), 594-602. DOI: 10.1089/bfm.2021.0032
Zholtikov V, Korableva N, Lebedeva J. Tuberous Breast Deformity Correction: 12-year Experience. Aesthetic Plast Surg 2019; 43: 16–26. DOI: 10.1007/s00266-018-1261-4
Sonkusale P, Kar S, Yadav N, et al. Pregnancy-associated hyperkeratosis of the nipple/areola. Journal of Mahatma Gandhi Institute of Medical Sciences 2019; 24: 96. DOI: 10.4103/jmgims.Jm gims _62_17
Groyecka A, Żelaźniewicz A, Misiak M, et al. Breast shape (ptosis) as a marker of a woman’s breast attractiveness and age: Evidence from Poland and Papua. American Journal of Human Biology; 29. Epub ahead of print 1 July 2017. DOI: 10.1002/AJHB.22981.
Mugea TT, Mugea TT. New breast volume and ptosis classifi cation system. Aesthetic Surgery of the Breast 2015; 605–633. DOI: 10.1007/978-3-662-434 07-9_32
Washer LL, Gutowski K. Breast implant infections. Infect Dis Clin North Am 2012; 26(1): 111–125. DOI: S0891-5520(11) 00078-X
Salibian AA, Frey JD, Bekisz JM, et al. Fat Grafting and Breast Augmentation: A Systematic Review of Primary Composite Augmentation. Plast Reconstr Surg Glob Open; 7. Epub ahead of print 1 July 2019. DOI: 10.1097/GOX.00000000 00002340.
Gentile P. Breast Silicone Gel Implants versus Autologous Fat Grafting: Biomaterials and Bioactive Materials in Comparison. Journal of Clinical Medicine 2021, Vol 10, Page 3310 2021; 10: 3310. DOI: 10.3390/jcm10153310
Junior IM, Graf RM, Ascenço ASK, et al. Is There a Breast Augmentation Outcome Difference Between Subfascial and Subglandular Implant Placement? A Prospective Randomized Double-Blinded Study. Aesthetic Plast Surg 2019; 43: 1429–1436. DOI: 10.1007/s00266-019-01465-8
Kirwan L, Wazir U, Mokbel K. Breast Auto-Augmentation: A Versatile Method of Breast Rehabilitation-A Retrospective Series of 107 Procedures. Arch Plast Surg 2015; 42: 438–445. DOI: 10.5999/aps. 2015.42.4.438
Graf RM, Closs Ono MC, Pace D, et al. Breast Auto-augmentation (Mastopexy and Lipofilling): An Option for Quitting Breast Implants. Aesthetic Plast Surg 2019; 43: 1133–1141. DOI: 10.1007/s 00266-019-01387-5
Bi S, Liu R, Wu B, et al. Breast Implants for Mammaplasty: An Umbrella Review of Meta-analyses of Multiple Complications. Aesthetic Plast Surg 2020; 44: 1988–1996. DOI: 10.1007/s00266-020-01866-0
Halpert G, Watad A, Tsur AM, et al. Autoimmune dysautonomia in women with silicone breast implants. J Autoimmun; 120. Epub ahead of print 1 June 2021. DOI: 10.1016/j.jaut.2021. 102631
Cohen Tervaert JW, Mohazab N, Redmond D, et al. Breast implant illness: scientific evidence of its existence. Expert Rev Clin Immunol 2022; 18: 15–29. DOI: 10.1080/1744666X.2022.2010546
Miseré RML, Colaris MJL, Tervaert JWC, et al. The Prevalence of Self-Reported Health Complaints and Health-Related Quality of Life in Women With Breast Implants. Aesthet Surg J 2021; 41: 661–668. DOI: 10.1093/asj/sjaa207
Newby JM, Tang S, Faasse K, et al. Understanding Breast Implant Illness. Aesthet Surg J 2021; 41: 1367–1379. DOI: 10.1093/asj/sjaa329
Collett DJ, Rakhorst H, Lennox P, et al. Current Risk Estimate of Breast Implant-Associated Anaplastic Large Cell Lymphoma in Textured Breast Implants. Plast Reconstr Surg 2019; 143: 30S-40S. DOI: 10.1097/PRS.0000000000005567
Berben JA, Misere RML, Schop SJ, et al. The Influence of Personality on Health Complaints and Quality of Life in Women With Breast Implants. Aesthet Surg J 2023;43(2):245–252. DOI:10.10 93/asj/ sjac247
Delay E, Garson S, Tousson G, et al. Fat injection to the breast: technique, results, and indications based on 880 procedures over 10 years. Aesthet Surg J 2009; 29: 360–376. DOI: 10.1016/j.asj. 2009.08.010
Calobrace MB, Gabriel A. Mastopexy with Autoaugmentation and Fat Transfer. Clin Plast Surg 2021; 48: 17–32. DOI: 10.10 16/j.cps.2020.09.008
Sarantos P, Steven DMC, Dimitrios GG, Meletios PN, Grigorios FG, Joke T, et al. Fat Grafting and Auto-Augmentation Mastopexy After Breast Implant Removal: Technique and Evaluation of Outcomes Using BREAST-Q, Aesthetic Surgery Journal, 2021. 41(6): NP388–NP401. DOI:10.1093/asj/sjaa347
Calobrace MB and Mays C. Mastopexy with Auto-Augmentation and Fat Grafting. In Plastic and Aesthetic Regenerative Surgery and Fat Grafting: Clinical Application and Operative Techniques. Cham: Springer International Publishing, 2022:1067-1084. DOI:10.1007/978-3-030-77455-4_71
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