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Augmentation/Mastopexy after Massive Weight Loss - A Retrospective Analysis
Udayan Srivastava, BA; J. Peter Rubin, MD; Jeffrey A. Gusenoff, MD
University of Pittsburgh Medical Center
2013-03-13
Presenter: Udayan Srivastava, BA
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. Research study execution, data collection, data analysis, and abstract preparation were performed by the presenter (Udayan Srivastava).
Director Name: Joseph E. Losee, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Purpose: Massive weight loss (MWL) patients lacking autologous tissues must utilize implant augmentation. Our aims are to elucidate rates of implant malposition and breast ptosis in the MWL population undergoing augmentation/mastopexy and compare to a non-MWL population.
Methods: A retrospective review from 2003-2011 was performed to record age, BMI indices, implant malposition, and ptosis grade of MWL and non-MWL populations, preoperatively and postoperatively.
Results: 38 patients were MWL and 20 were non-MWL. MeanAge of MWL patients was 43.3±9.0 vs. 33.5±7.5 years in the non-MWL group (p=0.003); Mean CurrentBMI was 26.1±3.4 kg/m2 vs. 22.2±3.3 kg/m2 (p=0.004). Preoperatively MWL patients presented with 5.2% Grade 1 ptosis, 10.5% Grade 2, and 84.2% Grade 3; this was significantly different (p<0.001) from non-MWL patients. In the <100 days postoperative interval, 58.3% of MWL patients had Grade 0 ptosis, 37.5% Grade 1, and 4.2% Grade 3; in the 100-300 day interval, 42.9% Grade 0, 52.4% Grade 1, and 4.8% Grade 2; in the >300 day interval, 16.7% Grade 0, 38.9% Grade 1, and 44.4% Grade 2. Significant differences existed compared to non-MWL rates (p<0.05). Implant malposition in the MWL population was 4.2%(<100 days), 23.8%(100-300 days), and 55.5%(>300 days). No implant malposition was noted in non-MWL patients.
Conclusion: Postoperatively, the majority of MWL patients return to Grade 1 or 2 ptosis; the majority of non-MWL patients remain at Grade 0. The MWL population has a significantly increased risk of recurrent ptosis and implant malposition, reinforcing needs for appropriate counseling and further research into alternative techniques for augmentation/mastopexy.
