RESUMO
BACKGROUND: Augmentation mastopexy focus on restoring the youthful appearance of the female breast. Despite those benefits, there is large scarring to be considered, and the reduction of this side effect is the main goal to enhance the aesthetic result. This article aims to describe a variation of the L-shaped mastopexy technique without complex marking and performed in planes, which brings long-term results for patients undergoing this approach. METHODS: This is a retrospective, observational study, based on a series of cases conducted by the author. The preoperative appointment and the surgical technique are described, and divided into steps according to their components: cutaneous, glandular tissue, and muscular. RESULTS: Between January 2016 and July 2021, 632 women underwent surgery. The mean age was 38 years (18-71 years). The mean volume of implants was 285cc (175-550cc). All the implants used were round with a nanotextured surface. The mean tissue resected from each breast was 117g (5-550g). Follow-ups ranged from 12 to 84 months, and photographic documentation was performed from 30 days after surgery. Complications totaled 19.30% and were divided into minor - treated with expectant treatment, non-invasive or with the possibility of correction with local anesthesia, corresponding to 10.44%; and major - in which it was necessary to return to the operating room, corresponding to 8.86%. CONCLUSION: Multiplane L-Scar Mastopexy is a versatile and safe technique with predictable results, which allows the systematic treatment of the most diverse breast types, with complications similar to other already described and solidified techniques.
RESUMO
A abdominoplastia tem-se difundido mundialmente, tanto esteticamente como de forma reparadora, e novas técnicas estão surgindo com o objetivo de minimizar as complicações isquêmicas do retalho e melhorar o contorno corporal. No período de janeiro a julho de 2002, vinte e uma pacientes, do sexo feminino, com idade variando entre 39 e 54 anos, apresentando alteração no abdome do tipo III e IV de BOZOLA, foram submetidas a abdominoplastia associada à lipoaspiração do abdome e flancos e descolamento apenas da porção central para plicatura da diástase muscular de acordo com a técnica de Saldanha(2001). Foi realizado um estudo com doppler fluxometria colo- rida dos vasos epigástricos superiores, inferiores e suas perfurantes músculo cutâneas, no pré-operatório e no décimo quinto dia de pós-operatório, avaliando a vascularização da parede abdominal superior e inferior, contabilizando os ramos perfurantes, calibre e fluxo sangüíneo dos vasos. Este estudo comprovou, através de doppler fluxometria, a preservação dos vasos perfurantes na região periumbilical e hipocôndrio e o aumento do calibre dos vasos em 9 e do fluxo sangüíneo em 56. A manutenção da irrigação sangüínea do retalho foi demonstrada clinicamente, através da boa evolução da cicatriz e ausência de complicações, como necrose da borda do retalho e seroma.
Abdominoplasty surgery has spread universally, both as aesthetic and reconstructive procedures, and new techniques are appearing with the goal of minimizing ischemic complications of the flap and bettering body contour. From January 2002 to July 2002, twenty one female patients, range of 30 to 54 years, presenting abdominal alterations classified as type III and IV of Bozola, were submitted to abdominoplasty combined with abdominal and flank lipossuction and central portion undermining for muscular diastasis plication according to Saldanhas technique. Eco-doppler fluxometry of the superior and inferior epigastric vessels and of their cutaneous muscular perfurans was done preoperatively and 15 days after the surgery, assessing the superior and inferior abdominal wall circulation, counting the number of perfurans vessels, the diameter and vessels flow. This study showed, through eco-doppler fluxometry, perfurans vessel preservation at the periumbelical and hypocondric areas and enhancement of vessels diameter (9) and vessels flow (56). Blood flow maintenance was demonstrated clinically through the good scar evolution and absence of complications, as flap necrosis and seroma.