The ‘underwire bra’ mastopexy: a new option

Background: Standard mastopexy techniques generally involve dermal interruption with a possible reduction of the neurovascular supply to the nipple-areolar complex. The dermal layer is usually back-folded to sustain the breast, leading to deep changes in breast structure, with possible consequences in imaging and raising concerns for cancer prevention and staging. Methods: The technique presented here is based on the Pitanguy’s inverted T disepithelization pattern. Five to seven 2-mm-long dermal incisions are placed along a line 3-4 mm above the sulcus. The fascia is pinched through these accesses and sutured to the deep derma and the breast cone is reconfectioned by infolding the dermal layer and the gland. Between 2001 and 2005, 54 patients with isolated breast grade 2 or 3 ptosis were treated using this technique. The results were evaluated both at three months and two years after surgery. The patients were also asked to answer a questionnaire about the nipple-areolar complex sensitivity and its effects on social life. Results: Aesthetic results were good in all cases, with no significant difference between the two controls. nipple-areolar complex sensitivity alterations three months after surgery were minimal (19%) or null (81%) with no significant effect on social life and even better two years after surgery. No serious technique-related complication or “bottoming out” occurred. Conclusions: The technique presented here achieves a good and stable correction of ptosis with a good stabilization of the inframammary fold and minimal effects on nipple-areolar complex sensitivity and trophism. Transdermal sulcus blockage prevents inframammary fold migration and “bottoming out”.