Secondary Augmentation-Mastopexy: Outcome Analysis of 1664 Consecutive Procedures.

[BACKGROUND] The efficacy of 1-stage augmentation-mastopexy has been well established throughout the literature. Limited evidence exists examining outcomes in the secondary augmentation-mastopexy patient.

[OBJECTIVES] To evaluate the long-term safety and efficacy of secondary augmentation-mastopexy through an analysis of clinical outcomes.

[METHODS] A retrospective review of 847 patients who underwent 1664 consecutive secondary augmentation-mastopexy procedures from January 2009 to January 2021 was performed. Demographics, operative characteristics, and postoperative outcomes, including complication and reoperation rates were collected and analyzed.

[RESULTS] Over a mean follow-up period of 47 months (3 to 131 months), the complication rate was 11% (n = 94) with a reoperation rate of 8.7% (n = 74). Tissue-related complications occurred in 7.3% (n = 62) and implant-related complications in 3.8% (n = 32). Indications for reoperation were primarily due to tissue-related complications in 5.4% (n = 46), most commonly recurrent ptosis in 3.4% (n = 29). Implant-related indications for reoperation (3.3%, n = 28) were most commonly capsular contracture (Baker III or IV; n = 21, 2.5%) and implant malposition in (n = 11, 1.3%). Comparing the incidence of reoperation with the number of previous breast procedures identified a significant increase in reoperation rate for patients with 3 or more previous breast implant procedures (P = .041), as well as a significantly higher reoperation rate in patients with a history of tobacco use (P = .013).

[CONCLUSIONS] Secondary augmentation-mastopexy can be performed safely with low complication and reoperation rates. Success with this procedure is directly proportional to control of the soft tissue envelope, implant, pocket, and the nipple to inframammary fold distance. An individualized approach coupled with a thorough preoperative evaluation of these components should be employed for optimal results.

[LEVEL OF EVIDENCE: 4]  (Therapeutic).