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All-Seasons Vertical Augmentation Mastopexy

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Evidence-Based Cosmetic Breast Surgery

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Abstract

Augmentation mastopexy is still regarded with trepidation by some surgeons. The conventional view is that the operations are at cross-purposes: the implant stretches the skin envelope while the mastopexy tightens it. The limitations of nonvertical methods are exposed when an implant is introduced, such as added pressure on a long inferiorly based pedicle.

Clinical experience and laser perfusion data demonstrate that, when a vertical technique with a medial pedicle is used, the combined procedure is safe. A medial pedicle is well-perfused and preserves superficial nipple innervation from the 3rd, 4th, and 5th anterior cutaneous branches. A deep parenchymal attachment maintains deep innervation. The medial pedicle is preferred over a superior pedicle, which sacrifices deep nipple innervation.

The combined operation offers many synergies. Breast asymmetry, for example, is much easier to treat. Almost all cosmetic breast patients may be treated with either a breast augmentation or a vertical mammaplasty performed individually or in combination. Staging is unnecessary. A woman who lifts her breasts up with the cups of her hands to demonstrate what she wants is best served with an augmentation mastopexy.

Complications include persistent ptosis (8.7%), scar deformities (7.9%), delayed wound healing (7.1%), and asymmetry (6.0%). In secondary cases, the nipple/areola may require little or no elevation. The original surgical pattern does not need to be followed.

Patients report being “back to normal” 1 month after surgery. The mean pain rating is 5.3 on a scale of 1 (least pain) to 10 (worst pain). According to patient surveys, 84% of women are satisfied with their result, 94% would repeat the surgery, and 96% would recommend it to others. Almost all women (97%) are pleased with their decision to have implants. Self-esteem is improved in 86% of patients and 70% of women report an improved quality of life.

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  1. Swanson Center, Leawood, KS, USA

    Eric Swanson MD

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Swanson, E. (2017). All-Seasons Vertical Augmentation Mastopexy. In: Evidence-Based Cosmetic Breast Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-53958-4_7

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  • DOI: https://doi.org/10.1007/978-3-319-53958-4_7

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