Dermoglandular flaps for autologous augmentation during mastopexy after breast implant explantation: A five-year retrospective study.

Abstract

The number of patients requesting breast implant explantation without replacement has increased substantially. Breast deflation and recurrent ptosis are common reconstructive challenges following explantation. Dermoglandular flaps provide an autologous option for volume redistribution during mastopexy while avoiding prosthetic materials. To report a five-year single-center experience using dermoglandular flaps for autologous augmentation during mastopexy after breast implant explantation and explore factors associated with postoperative breast stability. This retrospective review involved 75 consecutive patients who underwent implant explantation and mastopexy with dermoglandular flap autoaugmentation between 2019 and 2024. Demographic data, implant characteristics, surgical variables, complications, and outcomes with a mean follow-up of 16 ± 6 months were analyzed. Univariate analysis and exploratory multivariable modeling were performed to assess associations with recurrent ptosis. Mean patient age was 45 ± 9 years. Indications for explantation included autoimmune/inflammatory syndrome induced by adjuvants-related and/or breast implant illness-related symptoms (31%), implant rupture (24%), capsular contracture grades III-IV (23%), and esthetic concerns (20%). The most commonly used flaps were lateral dermoglandular flaps (72%), followed by inferior (20%), superior (7%), and bipedicled flaps (1%). The overall complication rate was 15%. Recurrent ptosis occurred in 4% of patients and pseudoptosis or bottoming-out in occurred in 4%. Patients with recurrent ptosis had larger explanted implant volumes compared with those without recurrence (p < 0.05). Given the low number of events, this association should be interpreted as exploratory. Dermoglandular flaps appear to be a safe and versatile option for autologous augmentation and breast reshaping during implant removal, with acceptable complication rates and satisfactory medium-term stability. Larger explanted implant volumes may be associated with an increased risk of recurrent ptosis, highlighting the potential limitations of single-stage autoaugmentation in selected cases. III.