Hammock-shaped capsular flaps in repair of the bottoming-out and double-bubble deformity of augmentation mammaplasty / 中华医学美学美容杂志

Objective:To introduce a novel method to repair bottoming-out and double-bubble deformity after augmentation mammaplasty with a hammock-shaped capsular flap, and to evaluate its clinical effect of the related complications.Methods:From 2015 to 2019, a total of 16 patients (aged range from 23 to years, with average age of 33.4 years) were treated in the Department of Plastic Surgery, Shanghai Mylike Cosmetic Hospital. We performed a novel hammock-shaped capsular flap with periareolar incision. First of all, the periprosthetic capsule was widely separated from the lower pole of the breasts. Then the inframammary folds were anchored to the chest wall to eliminate the excess the cavity. Finally, the capsular flaps were raised up from both anterior and posterior leaf and resutured by fold tile shaped suture, in order to elevate the inframammary folds in aesthetic revision.Results:Only one case showed mild hematoma and healed after treatment. After 6 months follow-up, all the inframammary folds were elevated to the ideal position, and the double-bubble deformity was corrected with concealed scars and satisfactory shape and symmetry. Meanwhile, recurrent cases and capsule contraction were not observed.Conclusions:For patients with bottoming-out and double-bubble complications after augmentation mammaplasty, the use of hammock-shaped capsular flap can effectively revise the deformation. This technical refinement seems to afford stable outcomes with convenient operation and minor injury and produce satisfactorily clinical effects with fewer complications.

Endoscopic Correction of Inferior Implant Malposition in Augmented Breasts with Electrocauterization

Bottoming out is the term used to describe the inferior displacement of a breast implant after breast augmentation that results in increased distance between the nipple areolar complex and the inframammary fold. Conventional techniques for correcting bottoming out involve capsulectomy and capsulorrhaphy via an inframammary fold incision that is prone to cause large scar and increases the patient's burden. However, using an endoscopic approach via the axilla, we are able to correct bottoming out, resulting in a smaller scar and shorter recovery time. In this article, we present a novel and simple method to correct bottoming out using endoscopy and electrocauterization.