Secondary Mastoplasty for Repair of Unfavorable Results

Abstract

Secondary mastoplasty has seldom been discussed in the literature, but the basic support for repair of unsatisfactory results is adequate surgical evaluation. Careful analysis of both breasts is a mandatory step before surgical planning. The decision of the procedure must be taken with a good understanding between surgeon and patient, as she is already frustrated because of the primary operation. She should be warned about the potential risks and possible adverse outcomes owing to the peculiarity of each deformity. The surgeon must evaluate the presence of scars, the position of the nipple–areola complex (NAC), and symmetry of the breasts in addition to all the unaesthetic aspects of the previous operations. If a patient has already undergone more than one surgery, she will be too frustrated and upset with regard to the breast operation. The problem may be exacerbated if several of her friends who have undergone reduction mastoplasty and achieved satisfactory results. The most frequent situation is the unaesthetic position of the NAC, which may be too high. My cutaneous–adipose–glandular flap with superior pedicle is a useful procedure as it replaces the empty space on the upper pole of the breast where mammary gland is missing. In fact, in most patients the upper pole of the breast is flat which is the main complaint of patients.