One-Stage Augmentation and Mastopexy

INTRODUCTION: Combined augmentation and mastopexy is a challenging procedure and controversy still exists whether it should be performed as a one stage procedure. Our aim was to investigate the functional and aesthetic outcomes, complications and revision rates in patients after a single stage primary augmentation and mastopexy. METHODS: A retrospective review of 370 patients from a large private plastic surgery office who underwent single stage primary augmentation and mastopexy was performed. A variety of data were collected including patient demographics, reason for mastopexy, types of mastopexy performed, complications and revision rate. RESULTS: The most commonly used procedure was vertical augmentation mastopexy (51%). 57% of the patients had pre-operative ptosis grade 2, while 26% of the patients had ptosis grade 3. Overall, 123 patients had a complication (33%). Residual ptosis was the most common complication (22%) and occurred significantly more often (p<0.005) in patients with a pre-operative ptosis grade of 2 (31.1%), relative to either patients with grade 1 (6.7%) or grade 3 (13.0%). No significant difference between patients with grade 1 vs. grade 3 was seen (p=0.28). There were no differences in patients with complications relative to those without, with regards to BMI, age at time of surgery, and ptosis grade (p >0.05). An increase in the risk for residual ptosis with both vertical and periareolar mastopexy techniques was noted (p <0.001 and p=0.001, respectively).Figure 1: Residual Ptosis compared to ptosis grade.CONCLUSION: Residual ptosis was our most frequent complication, and was also the most common reason for reoperation. Patients with pre-operative grade 3 ptosis had a significantly lower rate of residual ptosis than patients with grade 2, and should be considered candidates for augmentation/mastopexy. Single-stage augmentation mastopexy is an acceptable and safe procedure for patients who desire improved appearance of their breast shape.