LAUSR

BACKGROUND An increasing number of women with breast implant removal whilst maintaining an acceptable projection and form. OBJECTIVES We propose a technique to remodel the breast after implant removal by the use of internal suture loops to project the breast, recruit abdominal and axillary tissue cranially and medially, and provide a matrix for lipofilling. METHODS A prospective analysis was performed of consecutive patients undergoing implant extraction followed by Power-Assisted Liposuction Loops and Lipofilling (PALLL). Patient characteristics, and the indication and volume of implant extraction and lipofilling, were measured. The aesthetic results were evaluated by two independent raters. Patient-reported satisfaction was measured by standardized questionnaires. RESULTS Implants in 52 patients with an average age of 55 and BMI of 23.7 were extracted followed by breast remodeling. 73% had implants for aesthetic reasons, 41% were smokers, and 43% of the reconstruction cases had radiotherapy. 28% had implant extraction for rupture, 58% for capsular contracture, and 14% due to pain and migration. The average volume of the implants removed was 292 cc, followed by an average lipofilling of 223 cc, giving a ratio of 0.76 to 1. Average tissue recruited by loops was 82.5cc. Independent raters measured 79% of results as good, 13% as acceptable, and 8% as requiring improvement. 80% of patients were satisfied to very satisfied. CONCLUSIONS We propose that implant extraction followed by PALLL can provide footprint definition, sustained projection and high patient satisfaction. Moreover, the recruitment of a vascularized adipo-cutaneous flap by loops allows a reduced ratio of fat grafting to implant volume.