Dermal suspension and parenchymal reshaping mastopexy after massive weight loss: statistical analysis with concomitant procedures from a prospective registry.

Abstract

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. 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. 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). 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.