Implant-based versus autologous mastopexy after massive weight loss: Complications and patient satisfaction

Mastopexy surgery is among the procedures most requested by patients after massive weight loss. Many require a florid and voluminous breast, which is achieved thanks to the implantation of a breast prosthesis. However, mastopexy surgery with the prosthesis, especially with skin and subcutaneous tissues tested by significant weight loss, hides numerous risks and pitfalls. Is it, therefore, worth proposing this operation to post-bariatric patients? The study aims to answer this question by comparing two cohorts of post-bariatric patients undergoing mastopexy surgery with autologous tissues (74 women) and mastopexy with prosthesis implantation (64 women). Data demonstrate that patients who have implanted prostheses have a higher complication rate (p = 0.016), in particular, a more frequent recurrence of breast ptosis (p = 0.003). At the same time, patients with autologous reconstruction had a higher rate of wound dehiscence (p = 0.015). Despite this, patient satisfaction rates were comparable between the two surgeries (p = 0.684) The results were compared with the latest literature to have a more holistic understanding of the debate. Level of evidence IV: Evidence obtained from multiple time series with or without the intervention, such as case studies. Dramatic results in uncontrolled trials might also be regarded as this type of evidence.