Mastopexy with an Implant and the Making of a Horizontal Flap of the Upper Pedicle, Simulating an Internal Bra

Introduction Mastopexy with an implant is undoubtedly one of the most challenging surgeries in cosmetic surgery since it involves two overlapping procedures. The aim of this study was to demonstrate that by using horizontal glandular flaps in the sulcus in mastopexy with implants, it is possible to reduce the number of postoperative complications. Methods Sixty-three female breast surgery patients with some degree of flaccidity who underwent surgery from July 2018 to January 2020 were selected. All surgeries were performed in one procedure with an initial resection of the excess skin associated with a horizontal flap of the upper pedicle that promoted the protection of the implants and decreased the surgical wound tension. Results Forty-seven patients were included in the sample, for a total of 94 breasts. The motivation of the surgery was esthetic in all cases. Related to complications, we had 1 (1.06%) case of seroma, 1 (1.06%) case suffering from areola necrosis, 6 (6.3%) cases with scar revisions, 10 (10.6%) cases with complications in the transition from the "T" and no case of hematoma, infection or extrusion of the implants. The follow-up time was 12 months. Conclusion This technique allows the surgeon to perform a resection of excess skin and place the implants in one procedure, thereby decreasing the tension in the suture line, protecting the implants and forming a protective stabilizing brace in the mammary groove.