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In studies with a follow-up spanning between 6 and 12 statistical analysis, only P < 0.05 is considered significant.
years, revision rate has been reported between 0% and
1.2%. [7,8] However, long-term 25 years study has shown a RESULTS
revision rate of 15.5% following primary augmentation
[9]
mammoplasty. On the other hand, revision rate following A total of 1,406 patients had augmentation mammoplasty
simultaneous augmentation mastopexy is considerably and augmentation mastopexy in muscle splitting
higher. The reported revision rate may vary from 0%, 16.7%, submuscular pocket by a single surgeon using round
and 25.8% respectively, depending on the duration of the cohesive gel textured silicone implants. Group A included
study and follow-up. [10-12] In both groups of patients, there is 1,298 augmentation mammoplasties, and Group B had 108
a noticeable time-dependent increase in the revision rate. simultaneous augmentation mastopexy. The mean age of the
The current article is an analysis of 10-year data in which patients in Group A and B was 29.6 ± 8.62 years (range:
1,406 consecutive cases of augmentation mammoplasty 18-67 years) and 32.2 ± 9.50 years (range: 18-67 years),
and simultaneous augmentation mastopexy using single respectively (P = 0.006). Mean follow-up was 4.5 years
technique was eviewed for an early comparative (range: 3 months to 10 years). Mean size of the implants
complications and revisions rate. The results confirm that in Group A and B was 340 ± 56.7 mL (range: 200-630 mL)
when augmentation mastopexy is carried out as a single and 308 ± 76.0 mL, respectively (range: 200-555 mL) (P =
procedure, it carries a higher rate of complication when 0.001) [Table 1]. Wound infection in Group A and B was
compared with augmentation mammoplasty performed seen in 0.6% and 3.7%, respectively (P = 0.010). Wound
alone. However, the higher number of early complications breakdown was seen in 1.1% in Group A as compared to
seen in the combine procedure is the addition of the 2 6.5% in Group B (P = 0.001). Hematoma was seen in 0.9%
distinctively individual procedures and not an exponential and 0% in Group A and B, respectively. Drains were used
rise. in 5.5% and 23.1% of Group A and Group B, respectively (P
= 0.001). Revision surgeries were performed in 1.4% and
METHODS 11.1% of Group A and B patients, respectively (P = 0.001).
Three patients developed late seromas in augmentation
Retrospective data were collected using patient’s charts. mammoplasty group, and all were treated conservatively
All patients who had augmentation mammoplasty and without any recurrence. A total of 5 patients were treated
simultaneous augmentation mastopexy in muscle splitting for Grade IV capsular contracture, of these patients, 4
biplane using round cohesive gel textured silicone implants (0.32%) belonged to the augmentation mammoplasty and
performed by author were selected. Patients were divided 1 (0.9%) from augmentation mammoplasty. There were no
in Group A, which included augmentation mammoplasties cases of deep venous thrombosis, pulmonaryembolism, or
alone, and Group B, who had simultaneous augmentation death in the series.
mastopexy.
DISCUSSION
All patients were operated under general anesthetic with
full muscle relaxation and with their arms abducted Simultaneous augmentation mastopexy has been cited as
and supported at an angle less than 90°. A single dose a technically demanding procedure with unpredictable
of intravenous cephalosporin was given to all patients at outcome with high nipple and skin flap necrosis, however,
induction time. Augmentation mammoplasty is performed a later article by the same author reported satisfactory
using inframammary incision, and periareolar, vertical or results. [13,14]
wise pattern scars were used for augmentation mastopexy
depending on the preoperative measurements and wishes Complications of augmentation mammoplasty and
of the patient. Muscle splitting submuscular pocket was simultaneous augmentation mastopexy may require a
used for implant placement and procedure is performed planned or an unplanned theater visit for surgical
as a day case. Drains were used in the earlier part of the intervention. Common early complications requiring
study period. All patients wore support brassiere for 3 surgical intervention are hematoma and periprosthetic
weeks as a routine. infection. In current series, the hematoma in Group A was
seen in 12 patients (0.9%). There were no hematomas seen
Earlier complications related to wound infection, wound in Group B when compared with a rate of 0.6% of
breakdown, hematoma, periprosthetic infection, use of hematoma in a large series of simultaneous mastopexy
drains, and size of the implants between the two groups Table 1: Relative age and implant size distribution
were compared. between two groups
Group A (1,298) Group B (108) P
The data analysis was done. The results were given in Age (years) range, 18-67 (29.6 ± 8.62) 18-67 (32.2 ± 9.50) 0.006
the text as mean ± standard deviation for quantitative/ (mean ± SD)
continuous variables and percentages for qualitative/ Mean implant 200-630 (340 ± 200-555 (308 ± 76) 0.001
categorical variables. Two-tailed independent t-test is used size (mL) range, 56.7)
for statistical significance between groups for quantitative/ (mean ± SD)
continuous variables and Chi-square/Fischer exact test SD: standard deviation
for qualitative/categorical variables between groups. In all
Plast Aesthet Res || Vol 3 || Issue 1 || Jan 15, 2016 27