One-Stage Mastopexy-Lipofilling in Cosmetic Breast Surgery: A Prospective Study.

Abstract

Mastopexy in combination with implant breast augmentation still remains a controversial topic in plastic surgery because of its complexity and its relative high rate of complications. To obviate the need of a breast implant, numerous authors described glandular rearrangement techniques to optimize upper pole fullness and breast projection. More recently, the combination of mastopexy and lipofilling has been described. The aim of this study is to report our experience on one-stage mastopexy-lipofilling in cosmetic breast surgery, describing our surgical technique and focusing on long-term esthetic results and patient-reported outcomes. A prospective observational study was performed including all patients underwent cosmetic one-stage mastopexy-lipofilling. Collected data included patient's age and BMI, smoking, preoperative and postoperative cup size and grade of ptosis, preoperative and postoperative distances between the upper part of the nipple areola complex and the inframammary fold and between the upper part of the nipple areola complex and the sternal notch, mean liposuction and fat injection volume, mean operating time and postoperative complications. Cosmetic results and patient satisfaction were evaluated using the 5 points Likert scale considering breast volume, shape, symmetry, quality of scars, nipple areola complex and donor site shape and global satisfaction. A total of 21 patients (42 breasts) were included with a mean follow-up of 13.8 months. Mean liposuction and injection volumes were 1070 mL and 230 mL, respectively. With respect to breast size, 11 patients (52.4%) showed an increase in one-cup size, while 10 patients (47.6%) showed a slight increase in volume without changing cup size. The mean NAC-SN and NAC-IMF distances decreased by an average of 3.7 cm and 1.7 cm, respectively. Regarding esthetic outcomes, the mean scores for breast volume, shape, symmetry, quality of scars, nipple areola complex and donor site shape were 4.1, 4.2, 4.9, 4, 4.6 and 5, respectively. With respect to patient satisfaction, mean scores for breast volume, shape, symmetry, quality of scars, nipple areola complex and donor site shape were 4.2, 5, 5, 4.7, 5 and 5, respectively. The achievement of a satisfactory outcome (> 4) was obtained in all patients but 1 with a mean score of 4.5 (3-5). The current study suggests that one-stage mastopexy-lipofilling is a safe technique, which leads with satisfactory outcomes allowing breast contouring and breast volume increase. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.