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Introduction: The skin presents structural and proteomic changes after bariatric surgery and cannot withstand the weight of the breasts, which leads to early residual flaccidity, requiring auxiliary support. The goal is to apply a nonabsorbable polypropylene-poliglecaprone absorbable auxiliary mesh support or Bustos silicone sheet, in the form of an “internal brassiere,” to support the skin in order to maintain the shape and flaccidity of the breasts comparable with those of normal breasts. Methods: Nine patients underwent mammoplasty in inverted T with modeling of tissue implants, reduction of breast volume, and wrapping with an auxiliary support mesh. Results: Flaccidity was not observed at an early stage and the condition was acceptable for up to 4 years of follow-up. One of the patients had a seroma, which was drained with good resolution. Another 24 patients will be operated according to the protocol and observed for 2 years by using mammography, ultrasonography, and magnetic resonance imaging. Conclusion: Reduction mammoplasty after bariatric surgery requires additional support for the mammary gland. The structurally altered skin could not support the weight of the breasts, resulting in early flaccidity. ■ ABSTRACT

Breast augmentation after bariatric surgery by using complementary prosthetic support for glandular containment