Simultaneous Mastopexy-Augmentation for Small Ptotic Breasts

Background: Small ptotic breasts present a unique reconstructive challenge. Mastopexy alone may correct mild ptosis but fails to restore volume and upper-pole fullness. Augmentation alone does not address nipple malposition or skin redundancy. Although combined augmentation-mastopexy addresses both, it has historically been associated with higher complication and revision rates. This review evaluates modern techniques supporting its use in small ptotic breasts. Methods: A focused literature review was done to assess surgical techniques, outcomes, and complications. Emphasis was placed on strategies such as dual-plane implant placement, conservative skin resection, and intraoperative tailor-tacking. Results: Simultaneous augmentation-mastopexy provides superior aesthetic outcomes compared with mastopexy alone due to reports of improved upper-pole fullness, projection, and durable nipple positioning. Contemporary techniques demonstrate complication and revision rates (1.9% to 15.3%) comparable to isolated procedures, with recurrent ptosis, scarring, and capsular contracture being the most common complications. Conclusion: Augmentation-mastopexy should be considered the preferred single-stage approach for small ptotic breasts, with modern techniques mitigating historical risks.