All Seasons Vertical Augmentation Mastopexy: A Simple Algorithm, Clinical Experience, and Patient-reported Outcomes

Area of Science:

• Plastic Surgery
• Aesthetic Surgery
• Breast Surgery

Background:

• Safety concerns regarding augmentation mastopexy exist, with staging recommended for high-risk patients.
• Previous studies often include multiple surgical techniques, necessitating specific evaluation of vertical augmentation mastopexy.
• A novel algorithm for treatment guidance is presented.

Purpose of the Study:

• To evaluate the safety and outcomes of vertical augmentation mastopexy without surgical staging.
• To assess complication rates, revision rates, and patient satisfaction.
• To introduce a treatment algorithm for combined breast ptosis correction and augmentation.

Main Methods:

• A retrospective review of 252 consecutive vertical augmentation mastopexies performed between 2002 and 2016.
• All procedures utilized a medially based pedicle and intraoperative nipple siting without staged surgery.
• Outcome data was collected via survey from a subset of 90 patients (2012-2016).

Main Results:

• The overall complication rate was 32.9%, with common issues including persistent ptosis and wound healing problems. No nipple loss occurred.
• Smokers had a significantly higher risk of complications (P < 0.01). Revision rate was 15.5%.
• Patient-reported outcomes showed improved quality of life (70%) and high willingness to repeat (94.4%) or recommend (95.6%) the surgery.

Conclusions:

• Vertical augmentation mastopexy is a safe and broadly applicable procedure, even without staging.
• A simple algorithm can guide treatment for patients seeking ptosis correction and upper pole fullness.
• Staging is deemed unnecessary for this surgical approach.