BACKGROUND:: An increasing number of women are presenting for mastopexy after massive weight loss. The authors analyzed data from a prospective registry of massive weight loss patients who underwent the dermal suspension and parenchymal reshaping mastopexy alone or with concomitant operations to assess safety and efficacy. METHODS:: One hundred eight female massive weight loss patients underwent mastopexy. Variables included operative time; time since gastric bypass; body mass index; revision; and complications such as seroma, dehiscence, hematoma, and infection. Univariate analyses were performed to assess outcome measures. RESULTS:: Ninety-one patients underwent mastopexy without implant [mean age, 43.7 ± 9 years; mean intraoperative time, 8.5 ± 3 hours (mastopexy plus concomitant procedures), mean body mass index, 28.3 ± 3.9; mean time since gastric bypass, 27.5 ± 13.4 months; mean follow-up, 7.3 months], whereas 17 had augmentation/mastopexy. Eighty-five of 91 patients (93.4 percent) had multiple procedures performed. Wound dehiscence was the most common complication in 26 patients (29.2 percent); however, breast-specific complications overall occurred in only eight patients (8.8 percent). Body mass index and operative time did not predict an increase in complication rates. Patients who underwent augmentation/mastopexy had a lower current body mass index than those who had mastopexy alone (p = 0.01). CONCLUSIONS:: Dermal suspension, parenchymal reshaping mastopexy is a safe, effective, and durable method of treating the deflated breast after massive weight loss. Although patients with massive weight loss are likely to present for longer procedures and have a higher rate of wound-healing complications, these complications occur most frequently in areas other than the breast.
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