Central Pedicle Breast Reshaping Combined With Poly-4-hydroxybutyrate Scaffold Reinforcement: A Technical Description and Preliminary Single-surgeon Experience.

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/m 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.