Augmentation/mastopexy: a 3-year review of a single surgeon's practice

Augmentation/mastopexy is of considerable interest to plastic surgeons who perform breast surgery because of its complexity as well as its high rate of legal claims. This single-surgeon, 3-year study evaluated complications, outcomes, and reoperation rates among 166 patients who underwent 171 procedures for primary and secondary augmentation and primary and secondary augmentation/mastopexy. Aspects of the treatment plan were reviewed, including classification of ptosis, procedure selection, surgical planning, and operative technique. There were 57 primary breast augmentations, 60 secondary breast augmentations, 17 primary mastopexies, eight secondary mastopexies, 23 primary augmentation/mastopexies, and 30 secondary augmentation/mastopexies. The 23 primary and 30 secondary augmentation/mastopexy patients had 17 percent and 23 percent complication rates, respectively. The revision rate for augmentation mastopexy was 8.7 percent for the primary group and 16.6 percent for the secondary group. For reference, primary augmentation and secondary augmentation had complication rates of 1.7 percent and 21.6 percent, respectively. Primary augmentation had a 1.7 percent revision rate compared with 18.7 percent for secondary augmentation. The authors reviewed the most common problems leading to a revision, which were capsular contracture and asymmetry correction. Other complications included size change and rupture. Primary augmentation/mastopexy is a commonly performed procedure and has a significantly higher complication rate than primary augmentation. Secondary augmentation/mastopexy is also common and has higher revision and complication rates.