Outcomes of Mastopexy Explantation: A Consecutive Series of 841 Patients

Abstract Background The number of women seeking breast implant removal is increasing. However, there are relatively few studies that evaluate outcomes of breast implant removal and mastopexy. Objectives This study evaluates complication and revision rates following simultaneous breast implant removal and mastopexy. Methods A retrospective review was performed of 841 consecutive patients who underwent simultaneous implant removal and mastopexy between January 1, 2018 and December 31, 2024 by a single surgeon. Demographic, operative, and prior surgical variables were collected. Complication and revision outcomes were analyzed per patient. Unadjusted associations were assessed using univariate logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). All tests were two-sided (α=0.05). Results Complications occurred in 40 patients (4.76%), with a total of 45 complication events. Revisions were performed in 39 patients (4.63%), totaling 40 revision events. In unadjusted analyses, age, BMI, implant size 395cc, the use of mesh, subglandular plane, history of any mastopexy, history of 2 or more prior augmentations, and history of existing capsular contracture or implant rupture were not statistically significantly associated with complication or revisions. Effect sizes were modest with wide confidence intervals (e.g., complications: age per 10 years OR 1.11, 95% CI 0.82–1.50; BMI per 5 kg/m2 OR 1.10, 95% CI 0.72–1.67). A history of ≥2 prior mastopexies was associated with significantly increased revision risk (OR 7.72, 95% CI 2.65–22.50). Multivariable modeling was not feasible due to the small number of events relative to covariates. Conclusions This study demonstrates that with careful patient selection, simultaneous breast implant removal and mastopexy can be performed safely and effectively. Care should be taken when performing this procedure in patients with a history of two or more mastopexy procedures as they may have an elevated risk of revision.