Journal Article

Influence of the Pectoralis Major Muscle Sling in Chest Wall-Based Flap Suspension After Vertical Mammaplasty: Ten-Year Follow-Up

Ruth Graf, André Ricardo Dall Oglio Tolazzi, Priscilla Balbinot, André Pazio, Pedro Miguel Valente and Renato da Silva Freitas

in Aesthetic Surgery Journal

Published on behalf of The American Society for Aesthetic Plastic Surgery

Volume 36, issue 10, pages 1113-1121
Published in print November 2016 | ISSN: 1090-820X
Published online July 2016 | e-ISSN: 1527-330X | DOI: http://dx.doi.org/10.1093/asj/sjw114
Influence of the Pectoralis Major Muscle Sling in Chest Wall-Based Flap Suspension After Vertical Mammaplasty: Ten-Year Follow-Up

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  • Dermatology
  • Surgery
  • Plastic and Reconstructive Surgery

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Background

The pectoralis muscle sling has proven to be a suitable alternative technique for long-term results in breast parenchyma suspension. Although the pectoralis muscle sling has been subjectively observed to reduce the bottoming-out effect with a bipedicled muscle flap (muscular loop), there has not been a study to objectively or numerically prove it.

Objectives

This study aimed to radiologically evaluate the influence of a pectoralis muscle sling in supporting the chest wall-based flap after a vertical breast-reduction technique.

Methods

Twenty-one female patients underwent a vertical breast reduction with the chest wall-based flap and were randomly divided into two subgroups. Ten patients were in subgroup (S), which consisted of patients with a muscle sling. Eleven patients without the muscle sling technique were assigned as a control group (C). Periodic radiological examinations were performed at 1, 3, 6, and 12 months and then at 10 years postoperatively to analyze the breast flap and any migration with respect to three titanium clips placed intraoperatively on the chest wall parenchyma flap.

Results

Patients in subgroup S had a significantly higher difference in migration of the chest wall-based flaps between the first day and 10 years postoperatively when compared with patients in subgroup C (P < .001), as shown by the distances measured between titanium clip locations.

Conclusions

After 10 years of follow-up, there were changes in chest wall-based flap bottoming-out in patients in whom a pectoralis major muscle sling was utilized compared with those patients without it. Thus, a pectoralis major muscle sling seems to provide greater and longer-lasting support to the flap position on the patient's chest.

Level of Evidence:

2 Therapeutic

Journal Article.  4296 words.  Illustrated.

Subjects: Dermatology ; Surgery ; Plastic and Reconstructive Surgery

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