Integrated Approach to Upper Body Shaping: Long Time Results.

[BACKGROUND] As the frequency of bariatric procedures rises, so does the demand for breast contouring operations. Massive weight loss results in ptotic breasts that are challenging to shape. However, concentrating solely on the breasts in the upper body leads to a state of imbalance. In this study, we aimed to add additional volume to the breast tissue by utilizing the lateral chest folds/back folds with combined upper body lifting procedures and show the long-term results.

[METHODS] Between January 2018 and June 2024, 24 patients presented to our clinic with a complaint of breast deformity due to massive weight loss. They were evaluated as a whole. Upper body lift and autoaugmentation mastopexy with a lateral thoracic region perforators-based flap were planned in a single stage. Dorsal soft tissue was also utilized for autoaugmentation in selected patients. The viability of the extended dorsal flaps was examined with the intraoperative indocyanine green angiography.

[RESULTS] The body contouring surgery was performed an average of 2.2 years after bariatric surgery. Autoaugmentation with extended fasciocutaneous flap procedures was performed in combination with other upper body lifting procedures according to the patient's needs. The postoperative follow-up period was 1 month to 5 years.

[CONCLUSIONS] In postbariatric patients, focusing only on the breast leads to aesthetic disharmony in the upper body. Using subcutaneous tissue in the autologous augmentation method eliminates sagging in the upper body and provides the desired volume to ptotic breasts. The five-year follow-up results demonstrate that this method provides long-lasting, satisfying results with minimal complications.

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