Surgical Treatment Options for Augmentation Post-Mastoplasty Breast Ptosis with Silicone Implants

Introduction: Breast ptosis is the descent of the nipple areola complex below its normal position. It can be primary or secondary to the use of implants and the treatment is always surgical. In secondary ptosis, surgical treatment consists of removing excess skin, elevation of the nipple areola complex, fixation of the gland while preserving its function, sensitivity and symmetry, manipulation of implants, capsule and placement plane. Objective: To demonstrate the main deformities that appear in breast ptosis after augmentation mastoplasty with silicone implants and the surgical treatment options for each of them. Method: A descriptive, longitudinal and prospective study was carried out, which included 36 patients who underwent surgery for augmentation mastoplasty with silicone implants who attended the breast surgery department of the Plastic Surgery service of the “Hermanos Ameijeiras” Hospital with breast ptosis, in the Period from October 2016 to March 2019. Results: The age group between 33 and 46 years prevailed 61%. Tissue atrophy 56% was the most frequent cause. Pseudoptosis prevailed 75%. Pexy with an undefined pedicle, periareolar closure and implant change was the most used technique in 44%. The least used technique was inverted T 8% and all of them it was associated with previous scars. The aesthetic result was good in 100% of the cases. Conclusions: Breast ptosis after augmentation mastoplasty with silicone cohesive gel implants has a multifactorial origin, so treatment must be personalized for each patient and more specifically for each breast.