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    New Technique Offers Alternative Treatment for Sagging Breasts After Weight Loss

    Spiral Flap Surgery vs. Breast Implants

    Results From Spiral Flap Technique continued...

    About one-fifth had tissue death in an area that was transferred, he says, but in most cases it resolved on its own.

    Overall, Hurwitz says, he has had good results with the flap technique. In all, 15 patients of the 100 asked for further enlargement with breast implants later.

    One downside, he says, is that "it's hard to tell [in advance] how big the breast will be."

    In a report of 18 patients who had the spiral flap technique, published in the Annals of Plastic Surgery in 2006, Hurwitz says that 14 of the 18 were pleased with results, although three of the 18 got breast implants later because they wanted more augmentation.

    One of the three who had tissue death needed more surgery to correct the problem. One patient did not like the back scar resulting from the tissue transfer, and two disliked the shape of the breast but did not come back for revisions.

    The spiral flap technique of improving breasts is more time-consuming, complicated, and expensive than traditional breast implants, Hurwitz says.

    The doctor's fees are about $16,000, he says, but include the breast reshaping along with body contouring. Hospital costs for two days are additional.

    The average doctor's fee for breast implants is about $4,000, according to the American Society of Plastic Surgeons.

    Alternative to Breast Implants: Who's a Candidate?

    A typical patient who does well with the spiral flap procedure is a woman who has lost about 100 pounds, Hurwitz says, either by diet and exercise, bariatric surgery, or a combination.

    Those who seek the flap surgery for breasts misshapen by aging or pregnancy can't be too thin, he says, because they don't have enough "donor" tissue and fat. Typically, Hurwitz says, women who get the best results have a body mass index (BMI) of 28 or higher. Under 25 is termed a healthy BMI.

    "If the BMI is under 26, a woman probably doesn't have enough fatty tissue to do this," Hurwitz tells WebMD.

    Deciding who might be a candidate for the spiral flap technique must be done on a case-by-case basis, says Scott Spear, MD, chief of plastic surgery at Georgetown University Hospital in Washington, D.C., who is familiar with the technique.

    "If patients have enough tissue [to be transferred], it is a good option," he says. Most patients do like the "two-fer'' advantage, he says, in that they also get some body contouring.

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