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One-Stage Mastopexy with Breast Augmentation: A Review of 321 Patients

Stevens, W Grant M.D.; Freeman, Mark E. M.D.; Stoker, David A. M.D.; Quardt, Suzanne M. M.D.; Cohen, Robert M.D.; Hirsch, Elliot M. M.D.

Plastic & Reconstructive Surgery:
doi: 10.1097/
Cosmetic: Original Articles

Background: One-stage mastopexy with breast augmentation is an increasingly popular procedure among patients. In the past 9 years, there has been a 506 percent increase in mastopexy procedures alone. Although some recommend a staged mastopexy and breast augmentation, there are currently no large studies evaluating the safety and efficacy of a one-stage procedure.

Methods: A retrospective chart review was conducted of 321 consecutive patients who underwent one-stage mastopexy and breast augmentation. Data collected included the following: patient characteristics, implant information, operative technique, and postoperative results. Complication and revision rates were calculated to evaluate the safety and efficacy of the one-stage procedure.

Results: No severe complications were recorded over an average of 40 months’ follow-up. The most common complication was deflation of a saline implant (3.7 percent), followed by poor scarring (2.5 percent), recurrent ptosis (2.2 percent), and areola asymmetry (2.2 percent). Forty-seven patients (14.6 percent) underwent some form of revision surgery following the one-stage procedure. Thirty-five (10.9 percent) of these were for an implant-related issue, whereas 12 patients (3.7 percent) underwent a tissue-related revision. This 10.9 percent implant-related revision rate is less than a previously documented 13.2 percent 3-year reoperation rate for breast augmentation alone. The authors’ 3.7 percent tissue-related revision rate also compares favorably to an 8.6 percent revision surgery rate in patients who underwent mastopexy alone.

Conclusions: Although it has been stated that the risks of a one-stage procedure are more than additive, the results of our review suggest otherwise. Although a revision rate of 14.6 percent is significant, it is far from the 100 percent reoperation rate required for a staged procedure.

Author Information

Marina del Rey and Los Angeles, Calif.

From Marina Plastic Surgery Associates and the Keck School of Medicine, University of Southern California.

Received for publication November 18, 2006; accepted February 27, 2007.

W. Grant Stevens, M.D., 4644 Lincoln Boulevard, Suite 552, Marina del Rey, Calif. 90292,

©2007American Society of Plastic Surgeons