Fascioglandular flap in T-inverted augmentation mastopexy: a prospective comparison of implant-associated complications and lower pole stability

Objective. To evaluate the effect of split-thickness fascioglandular flap (SFGF) on lower pole stability and complication rate after T-inverted augmentation mastopexy. Material and methods. A prospective study included 96 patients who underwent T-inverted augmentation mastopexy between May 2023 and March 2025. Patients were divided into two groups: the SFGF group (n=47) and the control group (n=49) with classical technique without autologous tissue support. Both groups were comparable in age, body mass index, and implant volume. The follow-up period was 12 months. The incidence of implant-associated complications (ptosis recurrence, bottoming-out, protrusion, implant migration, inframammary fold asymmetry) and dynamics of nipple-to-inframammary fold distance (N-IMF) were assessed. Results. In early postoperative period, no differences in N-IMF were found between groups (p>0.05). After the 3rd month, there were significant between-group differences (p<0.001) that persisted until 12 months. N-IMF increment over the follow-up period was +0.8 and +2.5 cm in both groups, respectively. The overall complication rate was lower in the SFGF group — 4 (8.5%) vs 19 (38.8%) in the control group (p<0.001). Lower pole stability was achieved in 91.5% and 63.3% of patients, respectively (p=0.001). Conclusion. Split-thickness fascioglandular flap is associated with greater lower pole stability and lower complication rate. These results require confirmation in larger studies with long-term follow-up.