Constricted Lower Pole Breast Correction with High-Cohesivity Silicone Gel Anatomical Implant: Results from a 13-Year Single-Surgeon Experience.

[BACKGROUND] Lower pole constricted breasts, part of the spectrum of tuberous breast deformities, significantly impact patients' self-esteem and body image. To address the complexity and variety of clinical presentation of this type of deformity, a wide assortment of different surgical approaches has been proposed. The authors sought to determine the effectiveness of high-cohesivity silicone gel texturized anatomical implants in correcting lower pole constricted breast, emphasizing implant choice and the role of implant features on patient outcomes.

[METHODS] The study retrospectively analyzed data from 468 Caucasian female patients treated from March 2009 to July 2022 for type I and II tuberous breast deformities. Surgical correction involved the use of extensive radial and horizontal scoring to release lower pole strictures and high-cohesiveness microtextured anatomical implants placement in a subfascial pocket. Major and minor complications during the follow-up were recorded.

[RESULTS] Implant volume ranged from 260cc to 495cc with an average of 345cc. We report minimal major complications (Baker grade III-IV capsular contracture 4.2%, implant rotation 1.4%) within a mean follow-up time of 60 months. Further implant-related complications including bottoming out, double-bubble deformity, and wrinkling were not observed.

[CONCLUSIONS] The selected surgical approach for correcting lower pole constricted breasts using high-cohesivity silicone gel texturized anatomical implants proves to be effective, offering predictable and satisfying outcomes for patients. The surgical approach, combining anatomical implant characteristics with precise lower pole expansion techniques, yielded stable, esthetically pleasing results that positively impacted patients' quality of life.

[LEVEL OF EVIDENCE IV] This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors  www.springer.com/00266 .