Campiglio Gianluca, Giacalone Vitalba
Private Practice, Campiglio Plastic Surgery Center, Via Tranquillo Cremona 12, 20145, Milan, Italy.
Postgraduate School of Plastic Surgery, University of Palermo, Palermo, Italy.
Aesthetic Plast Surg. 2025 Apr;49(7):2000-2006. doi: 10.1007/s00266-024-04618-6. Epub 2024 Dec 17.
Ptotic breast deformity arises from decreased breast tissue volume and skin laxity, causing descent of breast tissue due to gravity. Mastopexy lifts and reshapes the breast and can be potentially associated with breast implants in case of need of volume increase. However, this option is not accepted by all the patients. The extended autoaugmentation mastopexy (ESPA) incorporates an abdominal flap to increase breast volume without implants, reducing surgical time and offering stable long-term outcomes.
The authors propose modifying the superior pedicle vertical mammaplasty to include glandular tissue transposition and an abdominal flap. This aims to restore central mound projection, narrow the lower breast base, and raise the inframammary fold.
Twenty patients underwent superior pedicle extended autoaugmentation (ESPA) mammaplasty from 2020 to 2024. Patients, aged 25 to 45, with wide, low-lying breasts lacking central projection, were selected. Breast tissue was elevated on a superior dermal pedicle extended inferiorly to an abdominal flap and transposed into a prepectoral pocket. The inframammary fold was raised, and the dead space is closed using internal and external temporary sutures.
Patients tolerated well the procedure, with one developing a seroma, successfully managed. All 20 patients expressed high satisfaction with postoperative breast shape and size, with no desire for subsequent augmentation.
The technique extends the superior pedicle to include abdominal tissue, restoring central mound projection and modifying the inframammary fold. It reliably recreates a more youthful breast shape in suitable patients without the need for implants.
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乳房下垂畸形是由于乳房组织体积减少和皮肤松弛，导致乳房组织因重力而下垂。乳房上提术可提升并重塑乳房，在需要增加体积的情况下可能会与乳房植入物联合使用。然而，并非所有患者都接受这种选择。扩展自体增大乳房上提术（ESPA）采用腹部皮瓣来增加乳房体积而无需植入物，减少了手术时间并提供了稳定的长期效果。
作者提议对带蒂上垂直乳房成形术进行改良，包括腺体组织移位和腹部皮瓣。这旨在恢复中央隆起，缩小乳房下皱襞基底宽度，并抬高乳房下皱襞。
2020年至2024年期间，20例患者接受了带蒂上扩展自体增大乳房上提术（ESPA）。选择年龄在25至45岁之间、乳房宽且位置低、缺乏中央隆起的患者。乳房组织在向下延伸至腹部皮瓣的带蒂真皮蒂上提起，并转移至胸肌前间隙。抬高乳房下皱襞，使用内外临时缝线封闭死腔。
患者对手术耐受性良好，1例出现血清肿，已成功处理。所有20例患者对术后乳房形状和大小均表示高度满意，无需后续增大手术。
该技术将带蒂上部分扩展至包括腹部组织，恢复中央隆起并改良乳房下皱襞。它能可靠地为合适的患者重塑更年轻的乳房形状，而无需植入物。
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