title: Augmentation mammoplasty/mastopexy: lessons learned from 107 aesthetic cases.
abstract: BACKGROUND
  One-stage augmentation/mastopexy entails the challenge of augmenting breast volume with an implant while resecting excess skin. Although both augmenting and lifting the breast in a one-stage operation is gaining in popularity, its safety and its efficacy are still under debate and merit deeper evaluation.
  
  
  METHODS
  We retrospectively reviewed our experience over a 5-years period with patients who underwent augmentation mammoplasty/mastopexy with the specific objectives of documenting their outcomes and formulating algorithms for safe, simple, and effective operative strategies to manage such patients. Our surgical approach to augmentation/mastopexy breast ptosis was described step by step. Patient satisfaction with the results was also evaluated.
  
  
  RESULTS
  One hundred seven patients underwent successful simultaneous augmentation/mastopexy surgery. Sixty-nine underwent primary breast surgery and 38 underwent secondary breast surgery. In 12 cases a periareolar mastopexy scar was used, while in 51 patients a vertical approach was preferred; in 11 and 33 patients a short "T" and an inverted "T" scar mastopexy was necessary, respectively. Few complications were observed, with a very low overall complication rate (14 %) and a reoperation rate of 12.1 % at 14.7 months. Patient satisfaction with the results of this procedure was extremely high.
  
  
  CONCLUSIONS
  Simultaneous augmentation/mastopexy is an effective and versatile way to lift the NAC, tighten the breast skin, increase breast projection, and fill in the upper pole. Our technique of simultaneous breast mastopexy after augmentation through a lower periareolar approach showed excellent correction of pre-existing ptosis, making this method highly reliable because the intraoperative tailor-tacking was customized to the patient, implant size, and projection.
authors.affiliation: Plastic Reconstructive and Aesthetic Surgery, Villa Salaria Clinic, Rome, Italy.
authors.forename: Manuel Francisco
authors.initials: MF
authors.lastname: Castello
authors.forename: Alessandro
authors.initials: A
authors.lastname: Silvestri
authors.forename: Fabio
authors.initials: F
authors.lastname: Nicoli
authors.forename: Talal
authors.initials: T
authors.lastname: Dashti
authors.forename: Sheng
authors.initials: S
authors.lastname: Han
authors.forename: Luca
authors.initials: L
authors.lastname: Grassetti
authors.forename: Matteo
authors.initials: M
authors.lastname: Torresetti
authors.forename: Aurelia Trisliana
authors.initials: AT
authors.lastname: Perdanasari
authors.forename: Yi Xin
authors.initials: YX
authors.lastname: Zhang
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Benedetto
authors.forename: Davide
authors.initials: D
authors.lastname: Lazzeri
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D019928:Breast Implantation / Q000379:methods; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D016896:Treatment Outcome