Combined Endoscopic Breast Augmentation-Mastopexy: Experience and Advantages
Goals/Purpose: Combined single-stage breast augmentation-mastopexy carries an increased risk of complications compared to either technique performed separately: malposition of implant, infection, and implant exposure through incisional breakdown. Endoscopic breast augmentation with mastopexy provides a protected pocket to reduce the risk of implant exposure or secondary infection.
Methods/Technique: A retrospective review was performed of eighty-four patients who underwent combined endoscopic augmentation/mastopexy over a three year period. All surgeries were by performed by one of three staff surgeons. Type and size of implant, type of mastopexy incision, and amount of tissue removed were evaluated. Patient satisfaction and any complications were noted.
Results/Complications: 84 patients underwent endoscopic augmentation/mastopexy over a three year period. 76 patients had saline implants and 8 had gel implants placed. The average implant size was 377ml with a range of 157 to 900ml. Mastopexies were performed through inverted T (63), vertical (20), or circumareolar (1) approaches. Resections ranged from skin only up to 657g/breast, with a mean of 160g/breast. 82 patients were pleased with their results, while only 2 reported being dissatisfied. 12 patients developed complications: with 5 patients requiring minor areolar or skin revisions in the office, 2 patients undergoing capsulotomy, 4 patients requiring treatment for superficial skin infections, and 1 patient requiring seroma aspiration. No patients experienced implant exposure or required implant removal. There were no reported complaints from patients regarding the additional axillary scar.
Conclusion: Combination breast augmentation-mastopexy is a surgical procedure which by many techniques carries an increased risk of complications including implant exposure. We believe that the risks of wound breakdown and associated implant exposure can be minimized by utilizing an endoscopic approach for breast augmentation during the combined procedure. Simultaneously, aesthetic appeal and patient satisfaction can be optimized.
