Charles A Messa2, Charles A Messa2. 1. Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Pennsylvania Health System, Philadelphia, PA. 2. Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Davie, FL.
Abstract
BACKGROUND: Although numerous studies supporting breast augmentation with simultaneous mastopexy have been reported, concerns persist among surgeons regarding the safety of this procedure. OBJECTIVES: The authors sought to evaluate the safety and effectiveness of 1-stage augmentation mastopexy by analyzing long-term complication and reoperation rates. METHODS: The authors conducted a retrospective review of 1131 patients who underwent 2183 consecutive 1-stage augmentation mastopexy procedures from January 2006 to August 2016. Patient demographics, operative technique, and implant specifications were measured and analyzed with surgical outcomes. Long-term complication and reoperation rates were noted. RESULTS: Over a mean follow-up period of 43 months (range, 4-121 months), the overall complication rate was 15.3% (n = 173) with a reoperation rate of 14.7% (n = 166). Tissue-related complications included hypertrophic scarring in 2.5% (n = 28) and recurrent ptosis in 2.1% (n = 24). The most common implant-related complication was capsular contracture (Baker III or IV) in 2.8% (n = 32). The most common indications for reoperation were recurrent ptosis in 3.5% (n = 40 patients) and desire to change implant size in 3.2% (n = 36 patients). Circumareolar augmentation mastopexy technique was associated with a higher reoperation rate of 25.7% (P < 0.0005). Patients with a history of smoking had a higher incidence of complications (26.1%) and reoperations (22.5%; P < 0.0005). There were no cases of significant skin flap necrosis (>2 cm). CONCLUSIONS: One-stage augmentation mastopexy can be safely performed with a reoperation rate that is significantly lower than when the procedure is staged. The effectiveness of this procedure is defined by a low complication rate and a reduced number of operations for the patient.
BACKGROUND: Although numerous studies supporting breast augmentation with simultaneous mastopexy have been reported, concerns persist among surgeons regarding the safety of this procedure. OBJECTIVES: The authors sought to evaluate the safety and effectiveness of 1-stage augmentation mastopexy by analyzing long-term complication and reoperation rates. METHODS: The authors conducted a retrospective review of 1131 patients who underwent 2183 consecutive 1-stage augmentation mastopexy procedures from January 2006 to August 2016. Patient demographics, operative technique, and implant specifications were measured and analyzed with surgical outcomes. Long-term complication and reoperation rates were noted. RESULTS: Over a mean follow-up period of 43 months (range, 4-121 months), the overall complication rate was 15.3% (n = 173) with a reoperation rate of 14.7% (n = 166). Tissue-related complications included hypertrophic scarring in 2.5% (n = 28) and recurrent ptosis in 2.1% (n = 24). The most common implant-related complication was capsular contracture (Baker III or IV) in 2.8% (n = 32). The most common indications for reoperation were recurrent ptosis in 3.5% (n = 40 patients) and desire to change implant size in 3.2% (n = 36 patients). Circumareolar augmentation mastopexy technique was associated with a higher reoperation rate of 25.7% (P < 0.0005). Patients with a history of smoking had a higher incidence of complications (26.1%) and reoperations (22.5%; P < 0.0005). There were no cases of significant skin flap necrosis (>2 cm). CONCLUSIONS: One-stage augmentation mastopexy can be safely performed with a reoperation rate that is significantly lower than when the procedure is staged. The effectiveness of this procedure is defined by a low complication rate and a reduced number of operations for the patient.