Page 92 - Read Online

Case Report Plastic and Aesthetic Research

Inferior dermoglandular flap for autologous

breast remodeling following explantation

of breast implants in ptotic breasts: a case

report and literature search

Umar Daraz Khan
Reshape Clinic, West Malling, ME19 6QR, Kent, UK.

Address for correspondence: Mr. Umar Daraz Khan, Reshape Clinic, Reshape House, 2-4 High Street, West Malling, ME19 6QR, Kent, UK.
E-mail: mrumarkhan@aol.com

ABSTRACT
Explantation following aesthetic mammoplasty without implant replacement is quite uncommon
and often leaves the patient worse off than prior to mammoplasty. A case is presented here in which
patient’s own tissue was used as an inferior dermoglandular flap for autologous breast remodeling.
Inferior dermal flap has been described for breast reconstruction and simultaneous augmentation
mammoplasty with mastopexy for prosthesis cover in the lower pole of the breast, but its use following
explantation without implant replacement has not been described for breast remodeling and volume
conservation.

Key words:
Autologous breast augmentation, bostwick flap, breast remodeling, explantation, revision augmentation
mammoplasty

INTRODUCTION loss of confidence is the reason that the explantation
alone following aesthetic augmentation mammoplasty
Augmentation mammoplasty is a commonly performed is not commonly performed. Breast remodeling in these
procedure. The procedure helps to enhance breast patients is often challenging and extremely important
cup size by filling out an empty breast skin envelope. and should be offered by a surgeon as an option, where
Following implantation skin gets further stretched and possible. A case report is presented where autologous
thinned down due to the pressure exerted by implants in breast tissue is used in the form de‑epithelialized inferior
a tight space. Explantation alone following augmentation dermoglandular flap for volume conservation and breast
mammoplasty is not very common. Removal of prosthesis remodeling along with simultaneous mastopexy using
results in loose, empty and often a ptotic breast skin Wise pattern markings following bilateral explantation of
envelope leaving patient worse off than prior to the breast implants.
procedure. Ptosis and skin excess may necessitate
mastopexy that may further reduce breast volume CASE REPORT
resulting in loss of female proportion and body silhouette.
This anticipated loss of feminine curves and accompanied A 42‑year‑old mother of 4 children and a care assistant
presented with neck and back ache. She had augmentation
mammoplasty 5 years ago using 450 mL Eurosilicone
Access this article online
anatomical implants. She considered her breasts too large
Quick Response Code: and was concerned with resultant neck and backache. She
Website:
www.parjournal.net requested removal of implants without replacement. She
requested reduction of her breast cup size down from
E to C.
DOI:
10.4103/2347-9264.153206 Examination showed a cup size of 34 E with jugular notch
to nipple areola complex distance of 26 cm. Her nipple to

Plast Aesthet Res || Vol 2 || Issue 2 || Mar 13, 2015 81