New Approach to Shaping a Ptotic Breast in Secondary Autologous Breast Reconstruction

Breast ptosis in women is mostly perceived as unattractive. It is associated with aging, breastfeeding, and multiple pregnancies. However, women who undergo radical mastectomy are the exception. They strive for a natural appearance and do not perceive a ptotic breast as unaesthetic. Shaping a ptotic breast from autologous tissue is one of the most challenging and difficult reconstructive procedures, especially because the risk of tissue failure has decreased significantly. The authors present their method of shaping a ptotic breast after a delayed autologous breast reconstruction. The technique, presented in detail, consists of dividing the native breast skin below the mastectomy scar into two dermocutaneous triangular flaps that carry the new breast. The dermocutaneous triangular flaps can be turned outward to decrease upper pole fullness and increase ptosis. Creating a carbon copy of the contralateral breast can be achieved during surgery. This report presents the results of the authors' method and discusses its advantages and disadvantages. In addition to its simplicity, this method gives ptosis up to grade 3 according to Regnault, frequently negating a mastopexy of the contralateral breast to reach symmetry. Equally important, the results have been stable in the long term.