M Bradley Calobrace1, Donald R Herdt, Kyle J Cothron. 1. Louisville, Ky. From private practice and the Division of Plastic Surgery, Department of Surgery, University of Louisville School of Medicine.
Abstract
BACKGROUND: Of all mastopexies performed in the authors' facility, approximately 77 percent of patients have an implant placed simultaneously. The unique challenges and safety concerns associated with the simultaneous augmentation/mastopexy procedure merit a deeper evaluation of its use and associated risks. METHODS: A retrospective analysis of 430 mastopexy operations, including 332 simultaneous augmentation mastopexies, was performed. Patient demographics, patient selection, and operative approach were evaluated and correlated with surgical outcomes. Complications and reoperation rates were measured and compared with published reports in the literature. RESULTS: For simultaneous augmentation/mastopexy procedures, the overall complication rate was 22.9 percent (primary cases, 20.4 percent; secondary cases, 28.9 percent). Tissue- and implant-related complication rates were 15.1 and 7.8 percent, respectively. The overall reoperation rate was 23.2 percent (primary cases, 20.0 percent; secondary cases, 30.9 percent). Tissue- and implant-related reoperation rates were 13.3 and 9.9 percent, respectively. The most common complications were capsular contracture (13 of 332), poor scarring (11 of 332), and recurrent ptosis (11 of 332). They were also the most common indications for reoperation (11 of 332 for each one). The mastopexy-only reoperation rate of 10.2 percent was comparable to the tissue-related reoperation rate of 13.3 percent. CONCLUSIONS: Although the measured reoperation rate (23.2 percent) may be higher than that of either procedure performed independently, the revision rate of combining the procedures was not more than additive. With appropriate patient selection and a carefully planned operative approach, the authors believe a one-stage procedure can be safely performed with acceptable complication and reoperation rates. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
BACKGROUND: Of all mastopexies performed in the authors' facility, approximately 77 percent of patients have an implant placed simultaneously. The unique challenges and safety concerns associated with the simultaneous augmentation/mastopexy procedure merit a deeper evaluation of its use and associated risks. METHODS: A retrospective analysis of 430 mastopexy operations, including 332 simultaneous augmentation mastopexies, was performed. Patient demographics, patient selection, and operative approach were evaluated and correlated with surgical outcomes. Complications and reoperation rates were measured and compared with published reports in the literature. RESULTS: For simultaneous augmentation/mastopexy procedures, the overall complication rate was 22.9 percent (primary cases, 20.4 percent; secondary cases, 28.9 percent). Tissue- and implant-related complication rates were 15.1 and 7.8 percent, respectively. The overall reoperation rate was 23.2 percent (primary cases, 20.0 percent; secondary cases, 30.9 percent). Tissue- and implant-related reoperation rates were 13.3 and 9.9 percent, respectively. The most common complications were capsular contracture (13 of 332), poor scarring (11 of 332), and recurrent ptosis (11 of 332). They were also the most common indications for reoperation (11 of 332 for each one). The mastopexy-only reoperation rate of 10.2 percent was comparable to the tissue-related reoperation rate of 13.3 percent. CONCLUSIONS: Although the measured reoperation rate (23.2 percent) may be higher than that of either procedure performed independently, the revision rate of combining the procedures was not more than additive. With appropriate patient selection and a carefully planned operative approach, the authors believe a one-stage procedure can be safely performed with acceptable complication and reoperation rates. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.