Role of Anatomical Implant in Augmentation of Glandular Ptotic Breast

ABSTRACT

Breast augmentation of ptotic micromastia is relatively difficult procedure than simple augmentation. Surgeon must make into account many variables, ptosis degree, chest wall size, shape, asymmetry, nipple and inframammary fold level, soft tissue characteristic etc. One-stage mastopexy augmentation procedure has higher patient acceptance because this limits the number of sick days and the need for hospital care, and it is also less expensive. Because of two procedures that has opposite effect to soft tissue be done in the same time, there can be high incidence of unfavorable outcomes and complications. Some well known doctors recommend that 2-step procedure of mastopexy folllowed by augmentation can be much better option. It can make more predictable result and it is also safe in soft tissue problem and vascularity. In one stage augmentation mastopexy, high and extrahigh projection implants have often been promoted for augmenting glandular ptotic breast, emphasizing the role of implant projection to the sagging parenchyma and skin of lower pole of breast anteriorly to "lift" the breast and "correct" the ptosis. High and extra high profile implants may contribute projection, but they are not the best choice for correction of glandular ptosis. It has several negatives, additional parenchymal atrophy, lower pole skin stretch and thinning and visible and palpable rippling. All of these tissue consequences are irreversible and uncorrectable. Optimal implant design for augmentation of glandular ptotic breast is full height, moderate profile, shaped, textured, form stable implant.