American Association of Plastic Surgeons

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A Comparison Of 2 Novel Single-stage Techniques For Mastopexy Augmentation And Mastopexy Exchange
Steven Kronowitz, MD.
Kronowitz Plastic Surgery, Houston, TX, USA.

Purpose: Concerns for single-stage mastopexy augmentation (MA) or mastopexy exchange (ME) has restrained many surgeons, who instead perform two stages at greater cost and patient risk.
Methods: The author compared two novel approaches to single-stage MA or ME referred to as mastopexy pocket augmentation (MpA) and mastopexy dermoglandular flap augmentation (MdfA) for complications (wound dehiscence requiring implant removal or the need for surgical revision).
Results: Between September 2015 and July 2023, the author performed aesthetic MA (MPA, 46 breasts; MdfA, 42 breasts) or ME (MpA, 26 breasts; MdfA, 26 breasts). Average patient age was 46 years (MpA, 47 years; MdfA, 45 years). Medical risk factors (MA, 40 breasts, ME 16 breasts; MpA, 36 breasts; MdfA, 20 breasts) Surgical risk factors (MA, 46 breasts, ME 24 breasts; MpA, 48 breasts; MdfA, 14 breasts) with average breast implant volume 370cc (MA, 362cc, ME, 400cc; MpA, 404cc, MdfA, 357cc). Overall complication rate was 1.4%. Complication rate for MA was 2.3% (MpA, 4.3%; MdfA, 0%) and there were no complications with ME. Complication rate for MpA was 2.8% and there were no complications with MdfA. MpA complications included a 47-year-old obese diabetic smoker with grade 3 ptosis who developed postoperative wound dehiscence with explanation (445cc implant); and 46-year-old (grade 3 ptosis and 445cc implant) who required surgical revision.
Conclusion: These novel techniques were safe and reliable even in high-risk patients. MdfA was preferable with MA, grade 3 ptosis, larger implants, diabetics, and smokers while MpA with ME, prior breast surgery and thin breasted patients.
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