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The Subtleties of Success in Simultaneous Augmentation-Mastopexy

Doshier, Laura J., M.D.; Eagan, Spencer L., M.D.; Shock, Leslie A., B.S., B.A.; Henry, Steven L., M.D.; Colbert, Stephen H., M.D.; Puckett, C. Lin, M.D.

Plastic and Reconstructive Surgery: September 2016 - Volume 138 - Issue 3 - p 585-592
doi: 10.1097/PRS.0000000000002517
Cosmetic: Original Articles
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Background: Many have challenged the safety of performing breast augmentation and mastopexy simultaneously. However, staging these procedures incurs the increased risk and inconvenience of two periods of anesthesia and recuperation. The authors set out to evaluate the occurrence of complications across the populations of patients undergoing (1) combined augmentation-mastopexy, (2) isolated augmentation, and (3) isolated mastopexy.

Methods: A retrospective analysis of one surgeon’s consecutive series of each of these procedures from 2000 to 2009 was conducted. Preoperative risk factors were characterized. Sixteen different complications were examined, and those necessitating operative revision were tracked. Statistical analysis was performed looking for significant differences between the surgical groups.

Results: No instances of infection, tissue loss, or implant exposure occurred among the 297 patients over an average follow-up period of 15.5 months. The isolated mastopexy group did not provide sufficient data for statistical comparison. Tissue-related complications were most common in the combined procedure group. The operative revision rate for isolated augmentation was 7.97 percent compared with a combined procedure revision rate of 12.4 percent (p = 0.28).

Conclusions: The majority of complications in this series comparing simultaneous augmentation-mastopexy to isolated augmentation were minor. Complications requiring operative revision were not found to be significantly different between the two groups. There was a much lower reoperation rate (12.4 percent) with the combined procedure compared with a 100 percent reoperation rate when the procedure is staged. Thus, the authors feel the combined procedure can safely be part of every plastic surgeon’s practice.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

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Columbia, Mo.; Kansas City, Mo.; and Austin, Texas

From the Division of Plastic Surgery, University of Missouri–Columbia; the University of Missouri–Kansas City, St. Luke’s Plastic Surgery Specialists; and the University of Texas Medical Branch, Institute of Reconstructive Plastic Surgery of Central Texas.

Received for publication October 2, 2015; accepted April 27, 2016.

Presented in part at the 55th Annual Meeting of the Plastic Surgery Research Council, in San Francisco, California, May 22 through 26, 2010.

Disclosure:The authors have no financial interests to declare. The University of Missouri Division of Plastic Surgery provided the only funding support for this project, and this was directed solely to the fees for biostatistical analysis.

C. Lin Puckett, M.D., Division of Plastic Surgery, University of Missouri, One Hospital Drive, Columbia, Mo. 65212, puckettc@health.missouri.edu

Copyright © 2016 by the American Society of Plastic Surgeons