Objective: To assess the rate of mammary prosthesis extrusion after mammoplasty with prosthesis implantation, to verify the resulting shape and the degree of patient satisfaction after the use of a transverse bipediculated flap with lateral irrigations. Methods: 30 patients with a weight loss of 50 kg on average after video-assisted bariatric surgery, with ptosis and excessive volumes, who underwent mammoplasty with prosthesis placement with volumes ranging from 190 to 260 cc, using a transverse flap with the aim of anchoring the silicone prosthesis. Results: In the patients’ evaluation, the few postoperative complaints did not amount to complications. Pains were minimal and the discomfort with the prosthesis was acceptable. Conclusion: the transverse flap, in addition to acting as the best anchor among the existing flaps for implanted prostheses, provided a youthful, natural, anatomical, aesthetic and longer lasting appearance for the breasts.