Tunahan Berk BASOL, Ersin AKSAM
Turkish Journal of Plastic Surgery - 2026;34(4):185-188
Obesity and subsequent bariatric surgery have increased the number of patients seeking postbariatric breast contouring procedures. Augmentation mastopexy in this population is particularly challenging, with higher complication rates and risks of implant malposition. We report a 50-year-old woman with a history of massive weight loss after sleeve gastrectomy, who presented with recurrent inferior malposition of the right breast implant following augmentation mastopexy. Despite undergoing seven revision surgeries using conventional techniques, implant malposition persisted. To correct the malposition, we designed a dermo-adipofascial flap based on lateral chest wall perforators to reinforce the inferior pole. Capsulectomy and capsulotomy were performed, and the flap was transposed and anchored like a hammock to create a stable inframammary fold. The left breast underwent capsulotomy for capsular contracture. Postoperative follow-up revealed prolonged drainage requiring extended drain placement and a minor seroma at the donor site, managed by aspiration. At 6 months, the implant remained stable with only mild asymmetry and no recurrence of malposition. Inferior implant malposition following augmentation mastopexy in postbariatric patients is a challenging complication, often resistant to conventional repair techniques. A dermo-adipofascial flap based on lateral chest wall perforators may serve as a reliable salvage option when traditional methods fail.
