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Erschienen in:
22.06.2023 | Original Paper
The spiral flap for breast auto-augmentation revisited
Erschienen in: European Journal of Plastic Surgery | Ausgabe 6/2023
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Background
Body contour deformities that develop following massive weight loss involve almost all areas of the body. Breast management after massive weight loss is performed for cosmetic and reconstructive purposes. It is critical to realize how these abnormalities affect the breast to handle those patients effectively.
Numerous studies demonstrated strategies to enhance breast projection, shape, and volume. These include breast reduction, augmentation using implants or local tissues of the chest wall, and/or the breast for breast auto-augmentation.
In this study, the efficacy of a superior pedicle for nipple-areolar complex (NAC) together with a spiral flap for breast auto-augmentation and elimination of back rolls in massive weight patients is evaluated.
Methods
This is a prospective case series study carried out on twenty female patients with massive weight loss and presenting for breast augmentation and/or lift. Breast auto-augmentation was done using a spiral flap harvested from the patient’s back and superior pedicle for the nipple-areolar complex (NAC). Results were evaluated according to the surgeon’s and patient’s satisfaction scores.
Results
The patients’ age ranged between 20 and 42 years old with a mean age of 35 years old. Their BMI ranged from 24 to 32 kg/m2 with a mean BMI of 28.9 kg/m2.Complications were all minor in nature and did not affect the overall results. Eighty percent of surgeons rated the results as excellent with a mean score of 8.25 (SD 0.77, score range is 0–9). Regarding patient’s satisfaction, the mean score was 13.15 with a maximum score of 15, which reflects the high satisfaction rate for the patients regarding the procedure and marked improvement in self-perception and body image.
Conclusions
Spiral flap represents a good option for breast auto-augmentation in massive weight loss patients. In addition to the upper body lift achieved, the use of a superior pedicle for NAC provides a better superior fullness for the breast mound. A longer follow-up, a larger sample size, and comparative studies are needed to achieve a stronger argument and a higher level of evidence.
Level of evidence: Level IV, Therapeutic.