16 - Breast Augmentation and Mastopexy

Abstract

Breast augmentation increases the volume of the breasts, and mastopexy lifts the nipple–areola complex and tightens the surrounding tissue to achieve a more youthful breast shape. The safety of performing breast augmentation and mastopexy simultaneously has been challenged previously because of the potential for complications with opposing forces of volume expansion and skin envelope reduction. Through refinement of techniques, this combination of procedures has now been shown to be performed safely in a single stage with good aesthetic outcomes and a low revision rate. Consequently, the popularity of simultaneous augmentation mastopexy has increased in recent years among both patients and plastic surgeons. A variety of mastopexy techniques can be used at the same time as breast augmentation, including crescent, circumareolar, circumvertical, Wise pattern, or others, depending on each patient’s anatomy. These techniques can be used in either the primary or secondary setting of augmentation mastopexy. In this chapter, the authors focus on their preferred approach to the circumvertical approach for primary augmentation mastopexy. The indications, contraindications, surgical technique with associated video, postoperative care, management of complications, secondary procedures, and pearls for success with circumvertical augmentation mastopexy are described in detail.