Background: An increasing number of women are presenting for mastopexy after massive weight loss (MWL).  We statistically analyzed data from a prospective registry of MWL patients who underwent the dermal suspension, parenchymal reshaping mastopexy alone or with concomitant operations to assess safety and efficacy.

Methods: 108 female MWL patients underwent mastopexy. Outcome measures included operative time, time since gastric bypass (GBP), pre-weight loss BMI, current BMI, delta BMI, revision, and complications such as seroma, dehiscence, hematoma, and infection.  Univariate analyses were performed to assess outcome measures.

Results: 91 patients underwent mastopexy alone (mean age 43.7 yrs ± 9, mean intra-op time 8.5 hours ± 3, mean BMI 28.3 ± 3.9, mean time since GBP 27.5 months ± 13.4, mean follow-up 7.3 months) while 17 had augmentation/mastopexy.  93.4% (85/91) had multiple procedures performed. Wound dehiscence was the most common complication in 26 patients (29.2%); however, breast specific complications (delayed healing and seroma) occurred in only 8 patients (8.8%).  BMI indices, operative time, and a cut-off BMI of 35 did not predict an increase in complication rates.  Patients whom had an augment/mastopexy had lower current BMIs than those who had mastopexy alone (p=0.01).

Conclusion:  Dermal suspension, parenchymal reshaping mastopexy is a safe, effective, and durable method of treating the deflated breast after MWL.  Although patients with MWL are likely to present for longer procedures and have greater wound healing complications, these complications most frequently occur in areas other than the breasts.