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The “Shirt Pocket” Technique—An Alternative for Augmentation-Mastopexy
Authors:Marcus Vinícius Jardini Barbosa  Paulo Henrique Costa de Souza  Fbio Xerfan Nahas  Lydia Masako Ferreira
Institution:1.The Morphofunctional Laboratory of the Scholl of Medicine of the University of Franca, São Paulo, Brazil;2.Department of Plastic Surgery, Franca, São Paulo, Brazil;3.Division of Plastic Surgery of the Federal University of São Paulo, São Paulo, Brazil
Abstract:Augmentation-mastopexy is a frequent procedure with high rates of early recurrence of breast ptosis, mainly after subglandular approach. The dual-plane techniques, based on the cranial dissection of the pectoralis, is the most used, but this plane does not cover the inferior pole of the breast. Then, the possibility of a downward dissection of the muscle seems to be more reasonable to retain the implant and improve postoperative results. This study aimed to review the anatomy of the pectoralis in cadavers and the use of its downward dissection to create a pocket for breast implant as a “shirt pocket.” This maneuver was associated with a superior-based dermoglandular flap to overprotect the inferior pole. No complications were related in the postoperative period. The anatomic review showed that the “shirt pocket” is a safe option if done carefully. The technique demonstrated to be feasible and seemed to be effective, being another alternative to prevent early recurrence of breast ptosis in these procedures.
Keywords:breast  breast implants  plastic surgery  mammaplasty  pectoralis muscle
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