Benchmarking the outcomes of single-stage augmentation mastopexy against primary breast augmentation: a single surgeon’s experience of 905 consecutive cases

BACKGROUND: Augmentation mastopexy may be performed as a one or a two-stage procedure. Due to the opposing force vectors involved in the augmentation and in mastopexy, some surgeons advocate a two-stage procedure. The literature appears divided on whether a single or two-stage operation has a more favorable complications profile. The purpose of this review was to benchmark the outcomes of single-stage augmentation mastopexy (SAM) against those of a commonly performed aesthetic breast surgery operation (primary breast augmentation, BA) performed by the same surgeon, in the same setting and over the same period. METHODS: We reviewed electronic patient records of all consecutive female patients who underwent single-stage augmentation mastopexy and primary breast augmentation by the first author (P.M.) at our clinic, between April 2009 and May 2017 and had at least a 6 months' follow-up. The notes were analysed for patient demographics, implant characteristics and complications. Data from single-stage augmentation mastopexy was benchmarked against the outcomes of primary breast augmentations performed by the same surgeon, in the same time period and at the same clinic. RESULTS: 104 single-stage augmentation mastopexies and 801 primary breast augmentations were performed during this period with a mean follow-up of 15.4 months and 14.0 months respectively. The patients undergoing augmentation mastopexy were significantly more likely to be older, have a relatively higher BMI, have more children on average and were significantly less likely to use oral contraceptives. There was no statistically significant difference in the overall complication rate between patients who had single-stage augmentation mastopexy or primary breast augmentation. CONCLUSION: Our experience suggests that single-stage augmentation mastopexy has comparable outcomes to those of primary breast augmentation. Smokers were more likely to have a re-operation due to postoperative complication (seroma), but the rate of implant change was not different.