The versatile helium balloon mastopexy.

BACKGROUND Mastopexy is a challenging procedure, particularly with the trend toward procedures with lesser scarring. When combined with breast augmentation, the risk of complications is greater than with either component alone. OBJECTIVE An attempt was made to simplify mastopexy, giving a "what you see is what you get" result before any surgical bridges are crossed while minimizing disruption of the breast gland and its circulation. METHODS A variation of the L-shaped mastopexy technique was developed that uses tailor-tacking to delineate the amount and pattern of skin resection necessary to give the breast the desired shape. An oblique skin resection in the lower, outer quadrant of the breast provides a good environment for healing while allowing tightening of the skin brassiere in the vertical and horizontal planes. Skin undermining and pedicle formation are eliminated, as is reliance on a circumareolar suture. The procedure is called the "helium balloon" technique for the allusion to the ascent of the breasts as well as the configuration of the closed incisions. RESULTS Seventy-two patients underwent mastopexy or augmentation/mastopexy over a period of 3 years with good results and an acceptable rate of revisions and complications. The technique has recently been extended to mastopexy after lipoplasty breast reduction in 2 patients. CONCLUSIONS Mastopexy and augmentation/mastopexy can be performed with predictably good results and minimal risk of serious complication by following the principles outlined for the "helium balloon" technique.