Four-step Augmentation Mastopexy: Lift and Augmentation at Single Time (LAST)

Area of Science:

• Plastic Surgery
• Aesthetic Surgery

Background:

• Augmentation mastopexy presents significant challenges, particularly in achieving sustainable upper pole fullness and correcting lower pole ptosis.
• Existing techniques may lead to confusion regarding the optimal approach for combined breast lift and augmentation.

Purpose of the Study:

• To describe a novel technique for augmentation mastopexy that incorporates inferolateral muscular support for implants.
• To present the outcomes of patients who underwent this standardized 4-step surgical approach.

Main Methods:

• A modified subpectoral pocket with inferolateral muscular support was utilized.
• Independent surgical approaches were employed for the submuscular implant pocket and parenchymal resection/reshaping.
• A pre-established 4-step surgical sequence was followed for 266 patients from October 2015 to January 2019.

Main Results:

• >90% of patients reported satisfaction with aesthetic outcomes, including the absence of ptosis, at mid-term and long-term follow-up (39 months).
• No major complications were reported.
• The overall revision rate was 16%, decreasing to less than 5% after the learning curve progressed.

Conclusions:

• The described 4-step sequence and inferolateral muscular support offer a reliable and effective method for augmentation mastopexy.
• This technique helps prevent recurrence of lower pole ptosis and improves aesthetic results.
• Further studies and surgeon experience are needed to validate these findings in combined breast lift and augmentation procedures.