A differentiated approach to mastopexy technique in combined mammoplasty

Objective. To analyze own experience with a differentiated approach to combined mammoplasty with T-shaped mastopexy. Material and methods. An observational comparative study enrolled 63 patients with grade 4 post-lactation atrophy and ptosis of mammary glands. Patients were divided into three groups depending on clinical and ultrasonic breast tissue density. Patients underwent T-shaped mastopexy. In the 1st group, we used a de-epidermized lower flap, in the 2nd group — resection of the lower mammary slope, in the 3rd group — fixation of vertical, medial, and lateral mammary columns. Results. Postoperative results were assessed three years after surgery using questionnaires. Surgical and aesthetic complications, as well as patient satisfaction with outcomes were also estimated. Our algorithm for selecting a surgical approach based on breast tissue type in combined mammoplasty demonstrated highly positive results and can be recommended in clinical practice. Conclusion. A personalized approach based on breast tissue type and a differentiated technique for combined mammoplasty are necessary to achieve favorable and stable results after combined mammoplasty. Our experience provides an additional opportunity to prevent complications after combined mammoplasty and may be of great importance in plastic surgery.