Long-term outcomes after single-stage augmentation mastopexy: A ten-year series and risk stratification model.

[INTRODUCTION] The existing literature on single-stage augmentation mastopexy is largely limited to short follow-up (<1 year), single surgeon series or outcomes in highly specific subgroups. The study aims to report long-term contemporary outcomes for single-stage augmentation mastopexy and to propose a risk stratification tool.

[METHODS] Ten-year outcomes of consecutive cases of single-stage augmentation mastopexy between 2014-2024 were reported from a single center. Multivariate logistic regression identified risk factors for complication and re-operation and a risk-stratification tool was proposed.

[RESULTS] 289 cases of single-stage augmentation mastopexy (Wise, 40.5% [117/289]; vertical with lateral extension, 26.3% [76/289]; vertical, 24.6% [71/289]) were performed including 45 patients (15.6%) with a history of previous augmentation or mastopexy. At a median follow-up of 46 months, implant- and tissue-related related complications occurred in 6.6% (19/289) and 26.0% (75/289) of cases, respectively. Re-operation occurred in 19.4% (56/289), of which 21.6% (12/56) were performed under local anaesthetic. Re-operation rates under general anaesthetic were 10.6%, 14.6% and 18.4% at 1, 3 and 5 years, respectively. The most common re-operation was revision mastopexy (11/289, 3.8%), followed by nipple areolar complex revision (9/289, 3.1%). Previous augmentation or mastopexy (OR 3.58; 95% CI,1.27-10.07), high-projection implants (OR 1.84; 95% CI,1.02-3.32) and smoking (OR 2.46; 95% CI,1.13-5.33) were associated with complication and/or re-operation. Landmark analysis identified implant-related complications in 4.8% (5/104) beyond 3 years and 2.0% (1/50) after 5 years, while tissue-related complications occurred in 1.0% (1/104) after 3 years and were absent beyond 5 years.

[CONCLUSIONS] Single-stage augmentation mastopexy can be performed safely in well-selected patients with promising long-term complication and re-operation rates.