Rotating Abdominal Flap: A New and Simple Technique to Treat and Avoid Lower Pole Contour Deformities in Breast Augmentation

Abstract

Background: Double-contour deformity represents a common complication following inframammary fold lowering in augmentation mammaplasty that mostly occurs in patients with a short distance from the nipple to the inframammary fold or tight breasts. The authors describe a technique that consists of exploiting a cranially based abdominal fat flap that is hinged and rotated upward to correct or prevent this deformity. Methods: A retrospective study of two groups of patients was conducted. Group A comprised 25 patients who presented with visible double-contour deformity after breast augmentation; group B comprised 22 patients with a constricted lower pole and short distance from the nipple to the inframammary fold undergoing primary augmentation. Results: Of 25 patients in group 1, 22 showed good outcomes. Two patients experienced bilateral and one, unilateral undercorrection of the deformity. One patient had a liponecrotic mass that did not need treatment. No patients in group 2 experienced obvious double-contour deformities. In group 2, one patient showed unilateral excess volume on the medial breast pole and another developed a postoperative hematoma that reabsorbed within 4 weeks. Conclusions: In many patients, the occurrence of double-contour deformities is linked to the difference in thickness between the area above and below the natural breast fold. The rotated abdominal fat flap increases the thickness of the lower pole in the area between the old and new IMF, which lacked volume, thus treating double-contour deformities in many patients. The same technique can be used to avoid the risk of these deformities when performing primary augmentation in patients with a short distance from the nipple to the inframammary fold or tight breasts.