Mastopexia associada a implante de silicone submuscular ou subglandular: sistematiza？？o das escolhas e dificuldades

background: throughout history, the breasts are considered important to the femininity and self-esteem of women. in augmentation mammoplasty, organ function must be preserved. indications for the best tissue plane for coverage of silicone implants and association with mastopexy can be challenging. the aim of this study was to evaluate a series of cases of mastopexy associated with silicone implants. methods: a retrospective descriptive study was performed in patients who underwent mastopexy at the plastic surgery unit of the hospital daher lago sul (brasília, df, brazil). from july 2008 to july 2011, 243 patients with a mean age of 31.4 years underwent surgery. in 149 patients, the subglandular technique was used and in 94 patients, the submuscular technique was used. implant volume ranged from 150 ml to 400 ml. results: there were 174 cases of combined procedures. four patients who underwent surgery using the subglandular technique developed capsular contracture (grade ii). we followed up 7 cases of pseudoptosis with the submuscular technique and 14 cases of mammary ptosis with the subglandular technique. eight patients experienced a mobile implant resulting from muscle activity. the reoperation rate was 6.58%. conclusions: treatment of mammary ptosis associated with augmentation mammoplasty demands a complex combination of techniques and careful preoperative analysis in order to define the best techniques to be used; this procedure lowers the need for surgical revisions and allows harmonious, stable, and long-lasting results.