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than revision rates of 8.6% for mastopexy and 10.7% for 32.2 years (range: 18-67 years) with an average follow up
augmentation mammoplasty performed separately. [10,11] For of 4.5 years (range: 3 months to 10 years). All patients
this reason single stage augmentation mastopexy remains a had round textured cohesive gel silicone implants with
very challenging procedure for surgeons and often done in a mean size of 308 mL (range: 200-555 mL). Mean size
stages. The use of muscle splitting submuscular technique of implants in periareolar mastopexy, vertical scar and
for mastopexy with augmentation with earlier results has wise pattern mastopexy was 327 mL (range: 170-555 mL),
[7]
been described before. The current article includes a larger 277 mL (range: 200-525 mL), 252 mL (range: 200-300 mL)
series with longer follow up to compare early and long term respectively. Nipple-areolar complex (NAC) repositioning
results and to evaluate the efficacy of the procedure. were predominantly performed using medially based flaps.
Majority of the patient requiring mastopexy presented
METHODS with varying degree of bilateral class A to C ptosis (66.7%)
and a combination of ptosis (17.6%). Mean preoperative
Retrospective data was collected using patient’s charts. All suprasternal notch (SN) to NAC distance was 24.3 cm (range:
patients who had simultaneous augmentation mastopexy in 19-31 cm). Mean neo NAC was marked at 21.4 cm (range:
muscle splitting biplane using round cohesive gel textured 18.5-25 cm) from suprasternal notch using inframammary
silicone implants performed by author were selected. crease (IMC) as a reference. Mean postoperative suprasternal
notch to NAC distance was 20.8 cm (range: 18-24.5 cm).
All patients were operated under general anesthetic with Mean preoperative NAC to IMC distance was 8.9 cm (range:
full muscle relaxation and with their arms abducted and 4.5-14 cm). Mean postoperative NAC to IMC distance 9.7 cm
supported at an angle less than 90 degree. A single dose (range: 6.0-12.5 cm).
of intravenous cephalosporin was given to all patients at
induction time. Periareolar, vertical or wise pattern scars Mild to moderate wound infection noted in 4 (3.7%) and
were used for augmentation mastopexy depending on the minor wound breakdown were seen in 7 (6.5%) patients
preoperative measurements and wishes of the patient. respectively. Drains were used in 25 (23.1%) and there was
Muscle splitting submuscular pocket was used for implant no NAC necrosis, hematoma or DVT.
placement and procedure is performed as a day case. Drains
were used in the earlier part of the study period. All patients Revision surgery was performed in 12 (11.1%) patients. The
wore support brassiere for three weeks as a routine. most common reason for revision surgery was for redundant
skin excision at lower pole (16.7%) and vertical scar touch up
Earlier complications related to wound infection, wound (16.7%).
breakdown, haematoma, periprosthetic infection, use of
drains and size of the implants were analyzed. Patients Case 1
who had their implants placed in subglandular or partial
submuscular pockets were excluded from the series. A 31-year-old admin worker presented with a class C ptosis
without a history of breast volume loss, weight loss or
RESULTS pregnancy. On examination her breast cup size was 34 D
with a breast width of 15 cm each side. Her sternal notch
Between 2005 and 2015 augmentation mastopexy was to NAC distance was 24 cm and NAC to IMC distance of
performed in 108 patients. Mean age of the patient was 9 cm respectively. She was interested in going bigger but

Figure 1: (a-c) Preoperative views of a 31-year-old patient with grade C ptosis; (d-f) four months' postoperative views showing results following vertical
scar augmentation mastopexy with 250 mL moderate profile textured round cohesive gel silicone implants
22 Plast Aesthet Res || Vol 3 || Issue 1 || Jan 15, 2016