Implants and methods for mastopexy

Abstract

A mastopexy implant for maintaining the breast in an elevated and aesthetically pleasing position includes a lower pole support comprising end portions which may be affixed to the chest wall or to a previously installed upper suspension strut. The implant is loaded in an insertion device. The insertion device is inserted through a small incision and into a subcutaneous pocket created in an inferior half of the breast. The lower pole support may have various constructs and in one embodiment includes a unitary conformable mesh having a plurality of arm or band members which are attached across the breast parenchyma and to the chest wall.

1 - 21 . (canceled) 
     
     
         22 . A method for elevating a lower pole of a breast, comprising:
 providing a lower pole support and a positioning tool,   loading a tubular distal section of the positioning tool with the lower pole support,   delivering at least a portion of the lower pole support through an access incision with the positioning tool, and   anchoring the lower pole support around breast parenchyma to retain the breast in place.   
     
     
         23 . The method of  claim 22 , further comprising deploying the lower pole support by withdrawing the positioning tool through the access incision. 
     
     
         24 . The method of  claim 22 , further comprising positioning the lower pole support with the positioning tool within a body pocket formed by the access incision. 
     
     
         25 . The method of  claim 22 , further comprising delivering the lower pole support through a periareolar incision. 
     
     
         26 . The method of  claim 22 , wherein the lower pole support has at least of the following properties:
 (a) a three-dimensional shape;   (b) a two-dimensional shape;   (c) formed of a mesh material;   (d) bioabsorbable; and   (e) formed in a canoe shape.   
     
     
         27 . The method of  claim 22 , further comprising attaching a plurality of straps extending from the lower pole support to an upper pole suspension strut. 
     
     
         28 . The method of  claim 22 , further comprising attaching a plurality of straps extending from the lower pole support to the breast parenchyma. 
     
     
         29 . The method of  claim 22 , further comprising loading the lower pole support within the tubular distal section of the positioning tool. 
     
     
         30 . The method of  claim 22 , further comprising loading the lower pole support around the tubular distal section of the positioning tool. 
     
     
         31 . The method of  claim 28 , further comprising rolling the plurality of straps around the tubular distal section of the positioning tool. 
     
     
         32 . A minimally invasive method for placing a device to lift a breast and NAC of a patient from a first position to a second position comprising:
 making a first incision in a side of the breast;   creating a subcutaneous body pocket in an inferior portion of the breast;   advancing a lower pole support positioning tool though the first incision and into the body pocket;   deploying a lower pole support in the body pocket;   manipulating the body of the lower pole support to span the body pocket;   manipulating tissue of the breast and the NAC to the second position; and   attaching the lower pole support to supportive tissue to secure the breast and the NAC in the second position.   
     
     
         33 . The method of  claim 32 , further comprising creating a second incision on the side of the breast opposite to the first incision; and wherein the deploying step comprises deploying a lower pole support in the body pocket from the lower pole support positioning tool, the lower pole support comprising a body and plurality of upper straps and a plurality of lower straps. 
     
     
         34 . The method of  claim 33 , further comprising creating a third incision and a fourth incision near medial and lateral ends of an inframammary fold of the breast respectively and wherein the lower straps are manipulated through the third incision and fourth incision. 
     
     
         35 . The method of  claim 33 , wherein the first incision is made on a lateral side of the breast and the second incision is made on the medial side of the breast, and the lower support positioning tool is inserted into the body pocket at the lateral incision and extended to the vicinity of the medial incision. 
     
     
         36 . The method of  claim 35 , wherein at least one of the upper straps is grasped through the medial incision and the lower pole positioning tool is withdrawn from the lateral incision, thereby deploying the lower pole support. 
     
     
         37 . The method of  claim 36 , further comprising creating at least one of a periareolar incision to aid in adjusting and fixing the lower pole support. 
     
     
         38 . The method of  claim 33 , wherein attaching the lower pole support comprises attaching the plurality of upper and lower straps comprises deploying tacks through the straps and into the supportive tissue. 
     
     
         39 . The method of  claim 33 , wherein attaching the lower pole support comprises attaching the straps is performed by suturing the straps to anchors embedded in the support tissue. 
     
     
         40 . The method of  claim 32 , wherein the step of creating the subcutaneous body pocket is performed by wire subscision through at least one incision. 
     
     
         41 . The method of  claim 40 , wherein the step of creating the subcutaneous body pocket comprises forming at least one triangular shaped pocket. 
     
     
         42 . The method of  claim 32 , wherein the step of creating the subcutaneous body pocket is performed using electrocautery. 
     
     
         43 . The method of  claim 42 , further comprising creating a NAC incision above the NAC and wherein the electrocautery is performed through the NAC incision. 
     
     
         44 . The method of  claim 33 , wherein attaching the lower pole support comprises attaching the straps to the supportive tissue comprises attaching the straps to a breast supportive tissue selected from the group consisting of subglandular, fascial, and muscular tissue. 
     
     
         45 . The method of  claim 33 , wherein attaching the lower pole support comprises attaching the straps to the supportive tissue is performed via the incisions. 
     
     
         46 . The method of  claim 33 , wherein attaching the lower pole support comprises attaching the straps to the supportive tissue comprises attaching the straps to a chest wall using a resorbable fastener. 
     
     
         47 . The method of  claim 33 , wherein attaching the lower pole support comprises attaching the lower straps is performed prior to attaching the upper straps. 
     
     
         48 . The method of  claim 32 , wherein the step of deploying the lower pole support comprises deploying a mesh. 
     
     
         49 . The method of  claim 48 , wherein the step of manipulating the breast and NAC to the second position is performed by manipulating the mesh. 
     
     
         50 . The method of  claim 32 , further comprising removing skin above the NAC to form the second position for the NAC. 
     
     
         51 . The method of  claim 33 , further comprising creating at least one channel pocket extending from the body pocket to the support tissue, and wherein manipulating the upper straps comprises manipulating at least one upper strap through the channel pocket to the support tissue. 
     
     
         52 . The method of  claim 51 , wherein the body pocket is contiguous with the at least one channel pocket.