Modified Liacyr-Ribeiro Breast Reduction and Mastopexy: Long-Term Outcomes with More Than 10 Years of Follow-up

BACKGROUND: Long-term maintenance of breast shape after reduction mammaplasty remains challenging, with inferior pole descent and pseudoptosis as possible late complications. The Modified Liacyr-Ribeiro Technique incorporates an inferior lipo-glandular flap fixed to the chest wall, functioning as an autologous prosthesis to improve internal support. Objective data beyond a decade remain scarce. This study evaluates long-term (>10 years) patient-reported and structural outcomes after the Modified Liacyr-Ribeiro Technique. METHODS: A single-center retrospective cohort with prospective follow-up assessment was conducted. Eighty-six patients undergoing bilateral reduction mammaplasty with our technique between 2010 and 2015 were included (mean follow-up of 14 years). Outcomes included patient-reported satisfaction and symptom relief, objective anthropometric measurements, surgeon clinical assessment, and blinded panel-based photographic evaluation. Multivariable regression analysis were used to identify predictors of long-term satisfaction. RESULTS: Overall, long-term satisfaction was high (mean score 4.48/5), with 86.0% of patients reporting high satisfaction. Objective clinical evaluation demonstrated stable breast shape, with adequate upper pole projection in 95.7% and correct nipple position in 97.8%. No cases of pseudoptosis were reported clinically. Blinded photographic assessment confirmed a very low prevalence of pseudoptosis (1%). Age, menopausal status, pregnancy, and postoperative weight variations - including extreme changes requiring bariatric surgery - did not negatively impact long-term satisfaction or structural outcomes. CONCLUSIONS: The Modified Liacyr-Ribeiro Technique provides durable structural support and sustained patient satisfaction over more than a decade of follow-up, supporting the autologous prosthesis concept as an effective strategy to preserve breast shape and prevent inferior pole descent, largely independent of major physiological stressors.