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Background and Objective: 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 (e.g., dehiscence, malposition, rupture, hematoma, scar issue) and revision rate.
Results: Patients average age was 37.5+8.3 years, while the average BMI was 23.6+3.4 (mean+SD). The most commonly used procedure was vertical augmentation mastopexy (178/352, 51%). Almost 57% of the patients had pre-operative ptosis grade 2, while 26% of the patients had ptosis grade 3. There were 113 patients (31%) who underwent a reoperation, primarily performed for residual ptosis or patient dissatisfaction with the appearance of her breast. Reoperation rates were higher in patients who had a vertical incision (p=0.047), underwent a concurrent minor procedure (p=0.010), had bacitracin irrigation (p=0.040) or were of increased age (p = 0.017). 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).
Conclusions: 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.