Background and objective.

Breast implant and mastopexy surgeries with implants have long being among the most performed breast Plastic Surgeries. However, for a large number of surgeons and patients, the decision between an implant or mastopexy can become quite difficult. In this sense, there has been an increase in the indication of mastopexy with implants, especially in patients in borderline situations, either from distancing from the nipple-areola complex (NAC) or in the continente-contents relationship of the breasts.

The aim of this paper is to propose our concept in breast implant surgeries for patients who do not accept mastopexy as a surgical strategy, to facilitate differential diagnosis and treatment, and to aid in decision making. We call this concept NAM (does Not Accept Mastopexy).

Methods.

The NAM algorithm was applied to 107 patients from 2021 to 2023: 100 patients had a NAC distance between 18 and 24 cm, and a distance fron NAC to submamary fold (SM) between 10 and 12 cm, Regnault's ptosis grade 1 and 2, and small to moderate flaccidity. All surgeries were performed under general anesthesia, and polyurethane implants were used in the subfascial plane.

Results.

After one year follow up, 102 were satisfied without the need for corrective mastopexy. Of the 5 patients who sought complementary mastopexy, only 2 were submitted to a complementary surgery.

Conclusions.

In our experience, the diagnosis and treatment based on the NAM concept was effective in preventing or postponing mastopexies.

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