Complications in augmentation mastopexy

Abstract

Breast augmentation with concurrent or secondary mastopexy is a common, yet complex, operation [1, 2]. It is discussed frequently at national and international meetings and in the plastic-surgery literature. Despite its success in improving the overall aesthetic appearance of the breast, caution is advised in the use of the procedure [3, 4]. Augmentation with mas-topexy remains one of the most frequently litigated operations in plastic surgery, primarily because of the litany of complications that can arise following this procedure [5]. This chapter will review such complications and provide clinical some pearls for their avoidance. Full uplift ed breasts with the nipple-areolar complex situated above the inframammary fold are the aesthetic destination of virtually all plastic surgery of the breast. On the one hand, fullness achieved by breast augmentation stretches the breast and areolar skin. In contradistinction, mastopexy is designed to reduce skin envelope excess while repositioning the nipple-areolar complex. These two operations have competing yet necessary goals, as volume deficiency and skin excess with ptosis are common clinical findings. A multitude of variables, associated with augmentation and mastopexy in addition to late changes following such operations, challenge the surgeon and can make it difficult, if not impossible, to predict the outcomes in certain cases. These factors lead to the numerous complications seen with augmentation mastopexy. Some of these concerns occur in the immediate perioperative period while others occur in the long term. A complication rate of 17% and revision rate of 8% by an experienced academic surgeon has been quoted for primary simultaneous augmentation mastopexy [5]. Another retrospective review of simultaneous breast augmentation with mastopexy demonstrated a 14.6% revision rate with the majority of complications being implant-related rather than tissue-related [6]. © 2009 Springer-Verlag Berlin Heidelberg.