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Pectoralis muscle sling in vertical mammoplasty provides longer-lasting results

Patients who underwent vertical mammoplasty with a pectoralis major muscle sling appeared to have significantly reduced chest wall-based flap bottoming out compared with patients who did not receive the sling, according to study results published in Aesthetic Surgery Journal.

“The ‘sling’ of muscle flap is fashioned parallel and from the fibers of the pectoralis major muscle,” Ruth Graf, MD, PhD, and colleagues wrote. “This loop uses the superficial two-thirds of the pectoralis major muscle fibers which avoids costal exposure and injury to lymphatic drainage. The chest wall-based flap is then released from all four sides (superior, inferior, medial, and lateral) and then passed under this muscle sling.”

Twenty-two female patients underwent vertical breast reduction between August 2003 and April 2015, with one patient lost to follow-up. The patients were separated into one group of 10 (study group) who received the muscle sling, and one group of 11 (control group) who did not.

The study group’s mean age was 46 years (range, 29-73 years) and the control group’s mean age was 40 years (range, 20-52 years). Over the follow up periods, there was a BMI variation of 1.47 to 7.14 kg/m² (mean variation, 4.38 kg/m² in the study group; 2.09 kg/m² in the control group).

A blind analysis of photographs taken preoperatively, and 1 year and 10 years postoperatively, and radiological images taken at 1 day and 10 years postoperatively, were reviewed for changes in fixed measurements, such as landmarks of the anterior chest, and variable measurements, such as the surgical clips used.

The researchers found a significant difference between the study group’s superior vertical, medial vertical and lateral vertical breast measurements compared with the control group (P < .001) in which the study group showed greater retardation of the bottom-out phenomenon.

“In recent years, one of the primary goals of modifying these standard techniques is to reduce scar morbidity and maintain upper-pole projection while maintaining the longevity of these results,” the researchers wrote. “This approach has provided subjective observations of significant reduction of the bottoming-out phenomenon over time.” – by Talitha Bennett

Disclosure: The researchers report no relevant financial disclosures.