Abstract
Introduction: Augmentation mastopexy is one of the more challenging surgeries. This article presents a new technique in which tailor tacking with skin staples provides maximum tightening of the redundant breast tissue and allows me to previsualize breast shape and symmetry—before the scalpel is raised for a 1-stage skin resection. I believe this is a more precise approach than the standard technique of drawing a pattern, resecting skin, and then tailor tacking the tissues together. Materials and Methods: A total of 41 patients with moderate to severe ptosis and hypotrophy were reviewed for this article. They all had bilateral submuscular saline breast augmentation with bilateral mastopexy with this stapling technique. Surgeries were performed over a 5-year period. The technique is described in detail. Preoperative and postoperative photographs are provided. Results: Patients reported great satisfaction with their results. Only 6 had small areas that healed by secondary intention, and only 1 patient had a mildly hypertrophic scar. Subjectively, this technique allowed me to achieve consistent, reproducible symmetry with single en bloc tissue resection and with less anxiety and guesswork. Conclusions: This augmentation/mastopexy technique produces predictable and reproducible results regardless of the implant size or the amount of skin that needs to be resected. With the adage of measure twice, cut once, it is very comforting to be able to preview the surgery results before having to cut skin.