Implant-based versus autologous mastopexy after massive weight loss: Complications and patient satisfaction

Mastopexy surgery is among the procedures most requested by patients after massive weight loss.Many require a florid and voluminous breast, which is achieved thanks to the implantation of a breast prosthesis.However, mastopexy surgery with the prosthesis, especially with skin and subcutaneous tissues tested by significant weight loss, hides numerous risks and pitfalls.Is it, therefore, worth proposing this operation to post-bariatric patients?The study aims to answer this question by comparing two cohorts of post-bariatric patients undergoing mastopexy surgery with autologous tissues (74 women) and mastopexy with prosthesis implantation (64 women).Data demonstrate that patients who have implanted prostheses have a higher complication rate (p= 0.016), in particular, a more frequent recurrence of breast ptosis (p=0.003).At the same time, patients with autologous reconstruction had a higher rate of wound dehiscence (p=0.015).Despite this, patient satisfaction rates were comparable between the two surgeries (p=0.684)Theresults were compared with the latest literature to have a more holistic understanding of the debate. Bullet point list:-Many MWL-patients require a florid and voluminous breast, which is achieved thanks to the implantation of a breast prosthesis, although the risks of mastopexy with prosthesis are greater than the risks of mastopexy with autologous tissues -Comparison of complications of autologous mastopexy versus mastopexy with prosthesis in postbariatric patients: confirmation that prosthesis implantation causes greater complications -The use of prostheses in post-bariatric patients is recommended only when strictly necessary to restore the volume Level of Evidence IV: Evidence obtained from multiple time series with or without the intervention, such as case studies.Dramatic results in uncontrolled trials might also be regarded as this type of evidence.

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Publication Details

Journal
JPRAS Open
Published
2026-02-04
DOI
https://doi.org/10.1016/j.jpra.2026.01.036
Primary Topic
Breast Implant and Reconstruction
Type
article
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article

Implant-based versus autologous mastopexy after massive weight loss: Complications and patient satisfaction

Vincenzo Vindigni, Franco Bassetto, Francesca Mancini, Valentina Budini et al.
JPRAS Open
Breast Implant and Reconstruction
article

Implant-based versus autologous mastopexy after massive weight loss: Complications and patient satisfaction

Vincenzo Vindigni, Franco Bassetto, Francesca Mancini, Valentina Budini, Patris Agaraj, Erica Geors, Francesca Zanon
article en

Abstract

Mastopexy surgery is among the procedures most requested by patients after massive weight loss.Many require a florid and voluminous breast, which is achieved thanks to the implantation of a breast prosthesis.However, mastopexy surgery with the prosthesis, especially with skin and subcutaneous tissues tested by significant weight loss, hides numerous risks and pitfalls.Is it, therefore, worth proposing this operation to post-bariatric patients?The study aims to answer this question by comparing two cohorts of post-bariatric patients undergoing mastopexy surgery with autologous tissues (74 women) and mastopexy with prosthesis implantation (64 women).Data demonstrate that patients who have implanted prostheses have a higher complication rate (p= 0.016), in particular, a more frequent recurrence of breast ptosis (p=0.003).At the same time, patients with autologous reconstruction had a higher rate of wound dehiscence (p=0.015).Despite this, patient satisfaction rates were comparable between the two surgeries (p=0.684)Theresults were compared with the latest literature to have a more holistic understanding of the debate. Bullet point list:-Many MWL-patients require a florid and voluminous breast, which is achieved thanks to the implantation of a breast prosthesis, although the risks of mastopexy with prosthesis are greater than the risks of mastopexy with autologous tissues -Comparison of complications of autologous mastopexy versus mastopexy with prosthesis in postbariatric patients: confirmation that prosthesis implantation causes greater complications -The use of prostheses in post-bariatric patients is recommended only when strictly necessary to restore the volume Level of Evidence IV: Evidence obtained from multiple time series with or without the intervention, such as case studies.Dramatic results in uncontrolled trials might also be regarded as this type of evidence.

JPRAS OpenVol. 49
University of Padua (IT)
Good health and well-being
Openalex Percentile: Top 67%
Breast Implant and Reconstruction
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