Central Pedicle Breast Reshaping Combined With Poly-4-hydroxybutyrate Scaffold Reinforcement: A Technical Description and Preliminary Single-surgeon Experience.
- 1From the Nery & Graziosi, Cirurgia Plástica Ltda., Niterói, Rio de Janeiro, Brazil.
Abstract
Background
Breast shape remains a persistent challenge following mastopexy, breast reduction, massive weight loss breast reshaping, revision surgery, and selected reconstructive procedures. The central pedicle preserves vascularized parenchyma, whereas poly-4-hydroxybutyrate (P4HB) scaffold reinforcement has been proposed as a soft-tissue support during postoperative remodeling. This study describes a single-surgeon experience combining these procedures.Methods
A retrospective review of an operative database was performed. Thirty patients undergoing breast reshaping using a central pedicle technique combined with P4HB scaffold reinforcement between June 2025 and April 2026 were included. Demographic variables, indication for surgery, mesh configuration, resection weights, and documented complications were analyzed.Results
The mean age was 42 years, and the mean body mass index was 24.8 kg/m². This cohort included massive weight loss breast reshaping (18 patients, 60.0%), aesthetic mastopexy/reduction (7 patients, 23.3%), explant/revision procedures (2 patients, 6.7%), late breast reconstruction (2 patients, 6.7%), and immediate breast reconstruction (1 patient, 3.3%). No patients were smokers, had diabetes, had a history of breast irradiation, or had breast implants at the time of surgery. Follow-up ranged from 3 to 12 months. The most common scaffold configuration was the origami construct (70.0%). No intraoperative or postoperative complications were recorded. One patient experienced transient inferolateral mesh palpability that resolved spontaneously after 4 weeks.Conclusions
In this preliminary single-surgeon experience, central pedicle breast reshaping combined with P4HB scaffold reinforcement was feasible. No major complications were observed. Objective measurements of recurrent ptosis, lower-pole stretch, projection maintenance, and patient-reported outcomes were not collected, so no conclusions regarding durability or superiority can be drawn. Prospective studies with standardized outcome assessment are warranted.
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BibTeX
@article{graziosi2026central,
title = {{Central Pedicle Breast Reshaping Combined With Poly-4-hydroxybutyrate Scaffold Reinforcement: A Technical Description and Preliminary Single-surgeon Experience.}},
author = {Guilherme Bracco Graziosi and André Luiz Viana Nery and Benedito Begnailson Ribeiro and Larissa Rosa Moreira and Flavio Augusto Amaral Tavora},
journal = {Plastic and reconstructive surgery. Global open},
year = {2026},
month = oct,
doi = {10.1097/gox.0000000000008201},
url = {https://europepmc.org/article/MED/42903425},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Central Pedicle Breast Reshaping Combined With Poly-4-hydroxybutyrate Scaffold Reinforcement: A Technical Description and Preliminary Single-surgeon Experience.
AU - Guilherme Bracco Graziosi
AU - André Luiz Viana Nery
AU - Benedito Begnailson Ribeiro
AU - Larissa Rosa Moreira
AU - Flavio Augusto Amaral Tavora
PY - 2026
DA - 2026/10/20
JO - Plastic and reconstructive surgery. Global open
DO - 10.1097/gox.0000000000008201
UR - https://europepmc.org/article/MED/42903425
AB - Background Breast shape remains a persistent challenge following mastopexy, breast reduction, massive weight loss breast reshaping, revision surgery, and selected reconstructive procedures. The central pedicle preserves vascularized parenchyma, whereas poly-4-hydroxybutyrate (P4HB) scaffold reinforcement has been proposed as a soft-tissue support during postoperative remodeling. This study describes a single-surgeon experience combining these procedures.Methods A retrospective review of an operative database was performed. Thirty patients undergoing breast reshaping using a central pedicle technique combined with P4HB scaffold reinforcement between June 2025 and April 2026 were included. Demographic variables, indication for surgery, mesh configuration, resection weights, and documented complications were analyzed.Results The mean age was 42 years, and the mean body mass index was 24.8 kg/m². This cohort included massive weight loss breast reshaping (18 patients, 60.0%), aesthetic mastopexy/reduction (7 patients, 23.3%), explant/revision procedures (2 patients, 6.7%), late breast reconstruction (2 patients, 6.7%), and immediate breast reconstruction (1 patient, 3.3%). No patients were smokers, had diabetes, had a history of breast irradiation, or had breast implants at the time of surgery. Follow-up ranged from 3 to 12 months. The most common scaffold configuration was the origami construct (70.0%). No intraoperative or postoperative complications were recorded. One patient experienced transient inferolateral mesh palpability that resolved spontaneously after 4 weeks.Conclusions In this preliminary single-surgeon experience, central pedicle breast reshaping combined with P4HB scaffold reinforcement was feasible. No major complications were observed. Objective measurements of recurrent ptosis, lower-pole stretch, projection maintenance, and patient-reported outcomes were not collected, so no conclusions regarding durability or superiority can be drawn. Prospective studies with standardized outcome assessment are warranted.
SN - 2169-7574
ER -