Avaliação radiológica do deslocamento vertical do retalho dermolipoglandular criado no polo mamário inferior e avançado sob o polo mamário superior para conferir-lhe maior projeção, entre a mamoplastia de pacientes previamente submetidas a cirurgia bariátrica e um ano após

Abstract

After massive weight loss surgery, the breasts usually exhibit ptosis, loss of projection and excess skin to the new volume. Several surgical techniques have been created to repair these breast changes. Many authors have guaranteed longlasting results after mammaplasty, but showed no evidential data. In 1971, Ribeiro isolated a thoracic based breast flap from the ptotic region. He moved it upwards and attached it to the pectoral fascia, posterior to the rest of the gland, to achieve upper pole fullness as an autoaugmentation mastopexy. According to the author, with this maneuver, the flap support became independent of the breast´s. Therefore, he concluded that the breast´s upper pole projection would be long lasting. Many studies have attempted to assess the recurrence of breast ptosis with the "Ribeiro flap", but not the ptosis of the "Ribeiro flap" itself. The main objective of this study was to measure the vertical displacement of this flap at the end of the healing process, observing the position of a titanium marker therein, by comparing chest radiographs performed one day and one year after mammaplasty. It also investigated intervening factors. The sample included 13 patients, 33 years old to 60 years old, on average 45 ± 10.14 years old at the time of breast surgery. All titanium markers moved caudally during the studied period, ranging from 0.6 cm to 4.1 cm, on average 2.4 cm ± 1.02 cm. Therefore, "the Ribeiro flap" used in mammaplasty of a patient undergone bariatric surgery descends. The greater the weight loss after mammaplasty, the greater the descent of the "Ribeiro flap". Such descent was not affected by the weight loss between bariatric surgery and plastic surgery, the vertical extent of breast tissue caudal to the inframammary crease just before plastic surgery, the vertical extent of the rise of the nipple-areola complex held in mammaplasty, the "Ribeiro flap's" thickness, the "Ribeiro flap's" volume or the breast volume at the end of mammaplasty. The statistical analysis used a significance level of 5%