A Systematic Review of Single-Stage Augmentation-Mastopexy

BACKGROUND: The safety of single-stage augmentation-mastopexy remains controversial given the dual purpose of increasing breast volume and decreasing the skin envelope. Currently, the literature is relatively sparse and heterogeneous. This systematic review considered complication profiles and pooled summary estimates in an attempt to guide surgical decision-making. METHODS: Multiple databases were queried for combined augmentation-mastopexy outcomes. Whenever possible, meta-analysis of complication rates was performed. RESULTS: Twenty-three studies met inclusion criteria. Average follow-up varied from 16 to 173 weeks, with a majority under 1 year. The pooled total complication rate was 13.1 percent (95 percent CI, 6.7 to 21.3 percent). The most common individual complication was recurrent ptosis, with an incidence of 5.2 percent (95 percent CI, 3.1 to 7.8 percent), followed by poor scarring (3.7 percent; 95 percent CI, 1.9 to 6.1 percent). The pooled incidences of capsular contracture and tissue-related asymmetry were 3.0 percent (95 percent CI, 1.4 to 5.0 percent) and 2.9 percent (95 percent CI, 1.2 to 5.4 percent), respectively. Infection, hematoma, and seroma were rare, with pooled incidences of less than 2 percent each. Three published studies reported data on patient satisfaction. The reoperation rate obtained from 13 studies was 10.7 percent (95 percent CI, 6.7 to 15.4 percent). CONCLUSIONS: This meta-analysis encompassed 4856 cases of simultaneous augmentation-mastopexy. Study heterogeneity was high because of differences in surgical techniques, outcome definitions, and follow-up durations. This review suggests that with careful patient selection, pooled complication and reoperation rates for single-stage augmentation-mastopexy are acceptably low.