Journal of Aesthetic & Reconstructive Surgery

Elastic Mastopexy Maintains Glandular Integrity, Augments the Upper Quadrant, and Prevents Recurrence of Ptosis

Background: Mastopexy is commonly defined as the removal of excess tissue, manipulation of the stroma and higher transposition of the nipple-areola complex. A breast implant is often inserted to project the upper quadrant. In reality, such operations would be more appropriately termed breast reduction and breast augmentation with skin removal. True mastopexy must keep the mammary stroma intact and never requires a prosthetic implant. The implantation of elastic threads (Elasticum EP4 Korpo SRL) that transform into a "ligament" prevents the recurrence of ptosis and enhances the upper quadrant.

Methods: The procedure involves de-epithelializing a shieldshaped area in the lower quadrant of the breast and reducing the diameter of the areola. The first elastic thread is implanted around the areola; if necessary, the apex of the breast is conized. Another elastic thread is implanted in order to create a suspensory ellipse. This thread runs from the anterior axillary pillar and through the subcutaneous tissue between the breast skin and the thoracic skin; it then passes at a slightly greater depth through the most prominent portion of the lower quadrant.

Results: Results were permanent. The breast is lifted, and the upper quadrant enlarged. This procedure significantly corrects breast asymmetry. If necessary we do an Adipofilling. The elasticum thread (polyester-coated silicone) is impalpable and does not cut into the tissues; when colonized by connective cells, it becomes a permanent "integrated ligament", making the correction of drooping stable.

Conclusion: Elastic mastopexy achieves stable esthetic modeling of the breasts, even heavy ones, under local anesthesia, while keeping the mammary stroma intact. The elastic suspension thread can be compared to a Cooper's ligament and is more resistant to the effects of gravity.

Author(s): Sergio Capurro*

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