Resumo

VENTURA, Omar-Darío. Surgical sequence in mastopexy with augmentation using implants: importance of a neutral or multimodal approach. Cir. plást. iberolatinoam. [online]. 2017, vol.43, n.1, pp.3-10. ISSN 1989-2055.

Background and Objective. Sagging breasts with volume reduction require a two-fold procedure consisting in augmentation using an implant, in most cases, and tissue adjustment to the new size. Leading experts in the field state that breast lift with augmentation is one of the most difficult procedures of Plastic Surgery. In sagging breasts requiring augmentation, the added volume of the prosthesis may change skin resection requirements, creating problems if the deepidermization surface has been miscalculated or logical doubts between a periareolar pexy or a vertical-periareolar technique. Our objective is to present the critical points of this surgery: 1. Areolomammillary positioning; 2. To define the marking of skin incision lines; 3. Approach; 4. Implantation planes; 5. Implant selection. Methods. We present a surgical sequence that will allow intraoperative variations in the planned technique of mastopexy with implants, and conduct a review of casuistry to base our evolution and development of the proposed methodology of work. Results. The procedure is collected in our surgical sequence as follows: 1. Deformity assessment; 2. Marking maximum and minimum dimensions of the eventual skin resection; 3. Neutral or multimodal approach; 4. Implants selection and placement; 5. Assessment of container-content imbalance to define skin compensations; 6. Breast assembly. Conclusions. Thanks to the exposed work methodology, we develop in this publication multiple indications that facilitate the treatment of this pathology.

Palavras-chave : Mastopexy; Breast implants; Mammary ptosis; Algorithm.

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