Simple Reshaping of the Breast in Massive Weight Loss Patients: Promising Preliminary Results

Background: The challenging breast reshaping after massive weight loss (MWL) has been increasingly performed as the number of bariatric surgery procedures increase worldwide. The breasts often appear wide, lateralized, and deflated, with significant ptosis. Objectives: The aim of this article is to share our initial experience using the lower pole subglandular advancement mastoplasty (LOPOSAM) technique to reshape the breasts in MWL patients and to elaborate the technical details and simplicity of the method in the attached video. Materials and Methods: We performed 30 LOPOSAM procedures in 15 MWL women aged 24 to 63 years from February to September 2015. We used a wise pattern mark-up and a superior based pedicle for the relocation of the nipple areola complex. The key step for the autoaugmentation was an inferior and central mound based parabola-shaped flap, which was placed in a subglandular pocket to reshape the breast and lift the inframammary crease. Results: The median operation time for the LOPOSAM procedure was 81 minutes (range, 35-160 minutes) by 2 surgeons. The median weight loss was 64 kg (range, 45-103) and 22 body mass index units ( range, 16-33) per patient. The median follow-up was 240 days (range, 105 Powered by Editorial Manager and ProduXion Manager from Aries Systems Corporation to 345). The surgical goal was achieved in all cases. Four complications occurred in 3 patients, 1 major, a hematomarequiring surgery and 3 minor wound dehiscence. The self-reported patient satisfaction was high, 13 were very satisfied with the result, 1 satisfied, and 1 less satisfied. Conclusions: The LOPOSAM technique is quick and simple to perform, and the preliminary results are promising. However, a longer follow-up is needed to confirm this.