Long Term Outcome Analysis Of Augmentation Mastopexy Patients: An 18-year Follow-up Of Simultaneous Superior Pole Projection And Inferior Pole Support
kaveh alizadeh, MD.
New York Medical College, New York, NY, USA.
PURPOSE: This study examines various techniques to determine how to provide the best long-term outcome for preservation of superior pole projection and inferior pole support in challenging mastopexy patients.
METHODS: This was a prospective cohort study of all augmentation mastopexy patients by one surgeon utilizing the same superiomedial pedicle mastopexy technique. A total of 655 patients (Age range: 21-68; average follow-up: 7.7 year) were enrolled between 2002 and 2021 of which 418 were followed for more than one year. An algorithm was developed to assign the patients to 3 groups:1) Primary correction of overstretched skin with simultaneous superior auto-augmentation and autologous inferior pole dermal flap support (N=207) 2) Secondary correction of augmentation mastopexy with autologous internal dermal flap (N=109) 3) Secondary Correction with ADM (N=102) Objective parameters utilizing 3-D Vectra analysis comparison of pre- and post-op photos were made to provide objective comparison of the breast projection with up to 18 year follow ups.
RESULTS: By 3 years after surgery, there was a statistically significant difference (p>0.1) in the position of the NAC, the superior pole projection, and the nipple inframammary distance in patients who received simultaneous auto-augmentation with inferior dermal flap support.
CONCLUSION: We describe the detailed anatomic technique for the consistent execution of simultaneous auto-augmentation and inferior pole support and provide an algorithm for categorization of these challenging patients. We believe that these techniques will allow a similar expectation of long term results like rhinoplasty and will ultimately lead to better outcomes in all mastopexy patients.
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