MINIMALLY-INVASIVE MASTOPLASTY PROCEDURE AND APPARATUS

1 . A method of performing a procedure to reposition portions of a breast having a nipple-areola complex (NAC) using a suture including a plurality of barbs, the barbs on a first portion of the suture between a first end of the suture and a first axial location on the suture for permitting movement of the suture through tissue in a direction of movement of the first end and preventing movement of the suture through tissue in a direction opposite the direction of movement of the first end, and the barbs on a second position of the suture between a second end of the suture and a second axial location on the suture permitting movement of the suture through tissue in a direction of movement of the second end and preventing movement of the suture through tissue in a direction opposite the direction of movement of the second end, the method comprising the steps of:

(a) inserting the first end of the suture through the skin of a patient at a first fixation point located cranially of the inframammary fold;

(b) causing the suture to engage a stable anatomical feature accessible from the first fixation point;

(c) deploying the first portion of the suture along a first deployment path through breast tissue to a first exit point located caudally of the first fixation point;

(d) deploying the second portion of the suture through breast tissue along a second deployment path to a second exit point located caudally of the first fixation point;

(e) advancing the breast tissue cranially relative to the first portion of the suture and the second portion of the suture to reposition the breast tissue towards the first fixation point.

2 . The method of claim 1 , wherein step (b) comprises causing the suture to engage a fascia pectoralis.

3 . The method of claim 2 , wherein:

step (c) comprises deploying the first portion of the suture along a first deployment path through breast tissue to a first exit point located caudally of the first fixation point and medially of the NAC; and

step (d) comprises deploying the second portion of the suture through breast tissue along a second deployment path to a second exit point located caudally of the first fixation point and laterally of th NAC.

4 . The method of claim 3 , wherein step (a) comprises inserting the first end of the suture through the skin of a patient at a first fixation point located close to one of the first rib, the second rib and the clavicle.

5 . The method of claim 4 , wherein:

step (c) comprises deploying the first portion of the suture along a first deployment path through breast tissue to a first exit point located medically of the NAC; and close to the lowest pre-surgery contour of the breast; and

step (d) comprises deploying the second portion of the suture through breast tissue along a second deployment path to a second exit point located laterally of the NAC and close to the lowest pre-surgery contour of the breast.

6 . The method of claim 5 , wherein:

step (c) comprises deploying the first portion of the suture along a first deployment path through shallow subcutaneous tissue so as to allow elevation of the NAC towards the fixation point; and

step (d) comprises deploying the second portion of the suture through shallow subcutaneous tissue so as to allow elevation of the NAC towards the fixation point.

7 . The method of claim 5 , wherein:

step (c) comprises deploying the first portion of the suture along a first deployment path through deep parenchymal tissue so as to allow elevation of the breast and NAC towards the fixation point; and

step (d) comprises deploying the second portion of the suture through deep parenchymal tissue so as to allow elevation of the breast and NAC towards the fixation point.

8 . The method of claim 1 , wherein:

step (c) comprises deploying the first portion of the suture along a first deployment path through shallow subcutaneous tissue so as to allow elevation of the NAC towards the fixation point; and

step (d) comprises deploying the second portion of the suture through shallow subcutaneous tissue so as to allow elevation of the NAC towards the fixation point.

9 . The method of claim 1 , wherein:

step (c) comprises deploying the first portion of the suture along a first deployment path through deep parenchymal tissue so as to allow elevation of the breast and NAC towards the fixation point; and

step (d) comprises deploying the second portion of the suture through deep parenchymal tissue so as to allow elevation of the breast and NAC towards the fixation point.

10 . The method of claim 1 , wherein:

step (c) comprises deploying the first portion of the suture along a first deployment path, which curves away from the NAC caudally of the NAC, through breast tissue to a first exit point located medially of the NAC; and

step (d) comprises deploying the second portion of the suture through breast tissue along a second deployment path, which curves away from the NAC caudally of the NAC, to a second exit point located laterally of the NAC.

11 . The method of claim 1 wherein step (b) further comprises:

causing the first end of the suture to exit through the skin of the patient at a second intermediate point lateral of the first fixation point; and

reinserting the first end of the suture through the skin of the patient at the first intermediate point.

12 . A method of performing a procedure to reposition portions of a breast having a nipple-areola complex (NAC) using a suture including a plurality of barbs, the barbs on a first portion of the suture between a first end of the suture and a first axial location on the suture for permitting movement of the suture through tissue in a direction of movement of the first end and preventing movement of the suture through tissue in a direction opposite the direction of movement of the first end, and the barbs on a second portion of the suture between a second end of the suture and a second axial location on the suture permitting movement of the suture through tissue in a direction of movement of the second end and preventing movement of the suture through tissue in a direction opposite the direction of movement of the second end, the method comprising the steps of:

(a) deploying the first portion of the suture caudally through breast tissue along a first deployment path from a first fixation point located cranially of the inframammary fold to a first exit point located on the breast caudally of the NAC;

(b) deploying the second portion of the suture caudally through breast tissue along a second deployment path from a second fixation point located cranially of the inframammary fold to a second exit point located on the breast caudally of the NAC; and

(c) advancing the breast tissue cranially relative to the first portion of the suture and the second portion of the suture to reposition the breast tissue towards the first and second fixation points.

13 . The method of claim 12 , further comprising engaging the suture with a stable anatomical feature adjacent the first fixation point.

14 . The method of claim 12 , further comprising engaging the suture with a fascia pectoralis adjacent the first fixation point.

15 . The method of claim 14 , wherein step (a) comprises deploying the first portion of the suture caudally through tissue along a first deployment path from a first fixation point located cranially of the inframammary fold to a first exit point located on the breast caudally of the NAC wherein the first fixation point is located close to one of the first rib, the second rib and the clavicle.

16 . The method of claim 12 wherein:

step (a) comprises deploying the first portion of the suture caudally through breast tissue along a first deployment path from a first fixation point located cranially of the inframammary fold to a first exit point located on the breast caudally and medically of the NAC; and

step (b) comprises deploying the second portion of the suture caudally through breast tissue along a second deployment path from a second fixation point located cranially of the inframammary fold to a second exit point located on the breast caudally and laterally of the NAC.

17 . The method of claim 12 wherein:

step (a) comprises deploying the first portion of the suture caudally through breast tissue along a first deployment path from the first fixation point located cranially of the inframammary fold to a first exit point located on the breast caudally and medially of the NAC and close to the lowest pre-surgery contour of the breast; and

step (b) comprises deploying the second portion of the suture caudally through breast tissue along a second deployment path from a second fixation point located cranially of the inframammary fold to a second exit point located on the breast caudally and laterally of the NAC and close to the lowest pre-surgery contour of the breast.

18 . The method of claim 12 wherein:

step (a) comprises deploying the first portion of the suture caudally through shallow subcutaneous breast tissue along a first deployment path from a first fixation point located cranially of the inframammary fold to a first exit point located on the breast caudally and medially of the NAC so as to allow elevation of the NAC towards the first fixation point; and

step (b) comprises deploying the second portion of the suture caudally through shallow subcutaneous breast tissue along a second deployment path from a second fixation point located cranially of the inframammary fold to a second exit point located on the breast caudally and laterally of the NAC so as to allow elevation of the NAC towards the second fixation point.

19 . The method of claim 12 wherein:

step (a) comprises deploying the first portion of the suture caudally through deep parenchymal breast tissue along a first deployment path from a first fixation point located cranially of the inframammary fold to a first exit point located on the breast caudally and medially of the ANC so as to allow elevation of the breast and NAC towards the first fixation point; and

step (b) comprises deploying the second portion of the suture caudally through deep parenchymal breast tissue along a second deployment path from a second fixation point located cranially of the inframammary fold to a second exit point located on the breast caudally and laterally of the NAC so as to allow elevation of the breast and NAC towards the second fixation point.

20 . The method of claim 12 , wherein step (b) comprises the deploying the second portion of the suture caudally through breast tissue along a second deployment path from a second fixation point located in the same place as the first fixation point to a second exit point located on the breast caudally of the NAC.

21 . The method of claim 12 , wherein step (b) comprises deploying the second portion of the suture laterally through breast tissue from the first fixation point to the second fixation point prior to deploying the second portion of the suture caudally through breast tissue along a second deployment path from a second fixation point to a second exit point located on the breast caudally of the NAC.

22 . The method of claim 12 , wherein step (b) comprises deploying the second portion of the suture laterally through the fascia pectoralis and breast tissue from the first fixation point to the second fixation point prior to deploying the second portion of the suture caudally through breast tissue along a second deployment path from a second fixation point to a second exit point coated on the breast caudally of the NAC.

23 . A suture implanted in tissues of a breast to maintain the tissues of the breast having a nipple-areola complex (NAC) in an elevated position wherein the suture comprises a first end, a second end, an intermediate portion, and a first barbed portion between the first end and the intermediate portion and second barbed portion between the second end and the intermediate portion and wherein:

the intermediate portion of the suture is engaged with a stable anatomical feature located cranially of the inframammary fold;

the first barbed portion of the suture is engaged with tissues of the breast located along a line extending caudally through tissue of the breast from the stable anatomical feature, the barbs on the first portion of the suture preventing the tissues of the breast from moving caudally relative to the st able anatomical feature; and

the second barbed portion of the suture is engaged with tissues of the breast located along a line extending caudally through tissues of the breast from the stable anatomical feature, the barbs on the second portion of the suture preventing the tissues of the breast from moving caudally relative to the stable anatomical feature.

24 . The suture of claim 23 , wherein the intermediate portion of the suture is engaged with the fascia pectoralis.

25 . The suture of claim 23 wherein:

the first barbed portion of the suture is engaged with tissues of the breast located along a line extending caudally through tissues of the breast coated medially of the NAC; and

the second barbed portion of the suture is engaged with tissues of the breast located along a line extending caudally through tissues of the breast located laterally of the NAC.

26 . the suture of claim 23 , wherein the intermediate portion of the suture is engaged with the fascia pectoralis in the region of one of the first rib, the second rib and the clavicle.

27 . The suture of claim 23 , wherein the first end of the suture and the second end of the suture are close to the lowest per-surgery contour of the breast.

28 . The suture of claim 23 , wherein:

the first barbed portion of the suture is engaged with shallow subcutaneous tissues of the breast located along a line extending caudally through tissues of the breast from the stable anatomical feature, the barbs on the first portion of the suture preventing the shallow subcutaneous tissues of the breast from moving caudally relative to the stable anatomical feature; and

the second barbed portion of the suture is engaged with shallow subcutaneous tissues of the breast located along a line extending caudally through tissues of the breast from the stable anatomical feature, the barbs on the second portion of the suture preventing the shallow subcutaneous tissues of the breast from moving caudally relative to the stable anatomical feature.

29 . The suture of claim 23 , wherein:

the first barbed portion of the suture is engaged with deep parenchymal tissues of the breast located along a line extending caudally through tissues of the breast from the stable anatomical feature, the barbs on the first portion of the suture preventing the deep parenchymal tissues of the breast from moving caudally relative to the stable anatomical feature and

the second barbed portion of the suture is engaged with deep parenchymal tissues of the breast located along a line extending caudally through tissues of the breast from the stable anatomical feature, the barbs on the second portion of the suture preventing the deep parenchymal tissues of the breast from moving caudally relative to the stable anatomical feature.

30 . The suture of claim 23 , wherein the first barbed portion and second barbed portion curve away from the NAC caudally of the NAC.