Introduction: Recurrent ptosis may occur after mastopexy procedures over time. The Volume Distribution Mastopexy (VDM) technique provides breast lifting with projection enhancement and maintains breast suspension.
Method: Since 2010, 50 patients underwent VDM procedures.
The technique consists of: a superior or superomedial pedicle, dissection of a Wuringer-septum based chest wall flap, suspension the flap to the pectoralis major muscle (PM) using a prosthetic mesh, gland suture to the mesh, and fat grafting if required.
A prospective study was conducted. Nipple position and length of the lower pole distance (LPD) of the breast were noted. The patients’ satisfaction and results evaluation was reported using a Likert scale.
Results: A Vicryl mesh was used in the first 23 patients and a Mixed Polystere/Vicryl mesh was used the following 27 patients. Wound dehiscence occurred in one patient. At an average follow up of 3 years, nipple position remained stable in position but LPD elongation was observed in 5 patients (20%) and in one patient (3%) who had Vicryl mesh and mixed mesh respectively (P<0,05). Only 4 breasts (4.7%) demonstrated significant lower pole elongation over time (>15%), all in the Vicryl mesh group. Worth noting, both the patients and the independent evaluators provided high rating of the result of 4.7 and 4.6, respectively, on a Likert scale.
Conclusion: The VDM technique repositions the ptotic gland with a mesh to suspend the breast gland and to maintain the lifting effect. However, the synthetic mixed mesh showed to be significantly more effective in achieving this goal.

Download