Superiorly Based Short-Scar Mastopexy Augmentation: A 10-Year Review of 1217 Consecutive Cases

Abstract

Background: Mastopexy augmentation is a challenging procedure, and a technique to create desirable, consistent, predictable results with a low rate of problems has not been well standardized. The inherent difficulty lies in competing surgical maneuvers. This study sought to evaluate the authors’ experience and describe the key concepts and steps that allow safe, efficient, predictable results with low complication and long-term reoperation rates. Methods: A 10-year retrospective review of all aesthetic breast operations between 2005 and 2015 was performed. Two senior surgeons (S.H.W. and H.C.W.) performed 1217 one-stage, superiorly based, short-scar mastopexy augmentation procedures. The data were evaluated in the context of other published series in the literature. Results: The overall revision rate was 4.8%. Patients who had undergone prior breast surgery were statistically more likely to require a revision compared with patients who had virgin breast tissue (10.4% versus 3.8%; P = 0.0005). Average follow-up was 39 months. Twenty-eight percent of revisions were performed more than 2 years after the original surgery; 16% were performed more than 6 years later. All revisions were included, regardless of procedure scope or timing. Of the 58 revision cases, 86% were purely implant or implant-pocket related; 7% were purely tissue related. There was one case of partial nipple necrosis. There were no cases of emergent reoperation, implant loss, implant exposure, or major wound dehiscence. Conclusions: The authors’ approach has been refined to maximize aesthetics, longevity, consistency, and surgical efficiency, and to minimize complications. This study demonstrates that safe and predictable results can be attained in one stage with low complication and reoperation rates.  CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.