A new device to improve mastopexy results?

One of the frustrating problems of breast surgery, particularly breast lift surgery, is the nature of the skin. It stretches out – frequently more quickly than either the patient or the surgeon would like, leading to a loss of the uplift or shaping effect of the mastopexy (breast lift).

Surgeons have been trying various methods for years to overcome this problem, with varying success. Literally dozens of different methodologies have been published – with varying results and acceptance.

One new idea, developed in South Africa, is the “breform” internal bra system. This is a soft, polypropylene fabric material, which is shaped much like the cup of a bra. At the time of breast lift surgery, it is implanted into the breast, about one-half inch beneath the skin, and secured to various fixed locations around the breast. Supposedly, it acts as an internal support system, reducing the problem with recurrent stretching out of the skin. This concept has been described in a similar way previously, by the South American Surgeon, JCS Goes. The Breform system uses a different mesh material, and features pre-sized, pre-formed implant shapes – making it an easier-to-use modification of Goes’ original idea.

And the early results reported seem promising. The breast shape seems to maintain itself much better than traditional mastopexy surgery.

Before you all get excited, though, let me state that the Breform system is not yet FDA approved – but has been used for a number of years in the U.K., Europe, and South Africa.

Concerns about this technique include:
– higher possibility of infection
– interference with mammography
– subcutaneous scarring / capsule formation around the mesh
– palpability of the mesh
– mesh exposure
– mesh malposition / asymmetry
– interference with subsequent breast surgery / breast biopsy

The proponents of this technique claim that the issues are not a significant problem with this product, but currently, their follow-up is only 4-5 years in length.

We’ll have to watch this technique with interest. The surgical results certainly look attractive, and the quoted complication rates appear low. Hopefully, one day it will become an option for American women as well.

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