One-Stage Augmentation Combined with Mastopexy: Aesthetic Results and Patient Satisfaction


Since the original descriptions by Gonzales-Ulloa in 1960 and Regnault in 1966, breast augmentation in combination with mastopexy has remained a difficult, and often polarizing, topic in plastic surgery, not only because of its results but also because of its litany of potential complications. Over the past few years, there has been an increase in the discussion of one-stage augmentation combined with mastopexy throughout the literature. However, a critical analysis of the aesthetic results, as well as patient satisfaction with the procedure, continues to be absent. Because there have not been any reported studies on the aesthetic results or patient satisfaction with augmentation and mastopexy, we undertook this retrospective review in an attempt answer a fundamental question: is one-stage breast augmentation combined with mastopexy aesthetically and functionally worthwhile for both the physician and patient? All 34 patients reviewed for this retrospective study underwent bilateral, one-stage breast augmentation and mastopexy between April 1996 and December 2002. Patient charts were reviewed for a number of parameters including previous breast surgery, degree of preoperative ptosis, type of mastopexy used, size and type of implants placed, implant position, postoperative complications, and any revision surgeries performed. Patient photographs were evaluated by observers blinded to the study, and patients were asked to complete a satisfaction questionnaire. Ptosis was graded according to the Regnault classification. As a result, 14 women had grade 1 ptosis (41%), fourteen had grade 2 ptosis (41%), one had grade 3 ptosis (3%), two had pseudoptosis (6%), and two had tuberous breasts (6%). The grade of ptosis in one patient was not defined. The patient complication rate was 8.8% (3 patients). For the aesthetic rating scale, preoperative and postoperative photographs taken after more than 1 year were evaluated. On the scale of 1 (poor) to 4 (excellent), overall ptosis correction was rated as 3.4, asymmetry correction as 3.4, postoperative breast symmetry as 3.2, scar quality as 3.3, breast shape as 3.1, nipple/areola size as 2.9, and overall result as 3. Only 13 of the 34 patients were available for completion of the satisfaction survey. Evaluation of the 13 patient satisfaction surveys showed that, on the average, the patients were satisfied with the various aspects of their surgery. The average overall result and surgical goals both were 3.1. However, 54% of the patients (n = 7) desired revision surgery for various reasons, the most common being a desire for more breast lift. A review of the patients and results, brought a number of issues to light. First, aesthetic results for augmentation and mastopexy truly depend on a number of different factors that must work in harmony to yield an excellent result. Second, what is aesthetically pleasing to the surgeon may not be pleasing to the patient, and vice versa. Third, although the patient aesthetic results were good, they were not consistently rated as excellent, nor were the patients totally satisfied with their outcomes. This perhaps reflects the more complex nature of both the patient’s problems and the surgical procedure itself. Finally, although the overall results of one-stage breast augmentation and mastopexy are good, and the patients generally are satisfied, this study raises the question whether staging the surgery by performing the mastopexy first may not yield significantly better results than the combined simultaneous procedure.

This is a preview of subscription content, log in to check access.


  1. 1.

    RJ Bartels DM Strickland Wm Douglas (1976) ArticleTitleA new mastopexy operation for mild or moderate breast ptosis Plast. Reconstr Surg 57 687 Occurrence Handle1:STN:280:CSmC1MfgvF0%3D Occurrence Handle1273148

    CAS  PubMed  Google Scholar 

  2. 2.

    LC Benelli (1990) ArticleTitleA new periareolar mammaplasty: The “round block” technique Aesthl Plast Surg 14 93 Occurrence Handle1:STN:280:By%2BB2c%2FhtlI%3D

    CAS  Google Scholar 

  3. 3.

    A la Fuente ParticleDe JL Martin Yerro Particledel (1992) ArticleTitlePeriareolar mastopexy with mammary implants Aesth Plast Surg 16 337

    Google Scholar 

  4. 4.

    LF Elliott (2002) ArticleTitleCircumareolar mastopexy with augmentation Clin Plast Surg 29 337 Occurrence Handle12365635

    PubMed  Google Scholar 

  5. 5.

    M Gonzales-Ulloa (1960) ArticleTitleCorrection of hypotrophy of the breast by exogenous material Plast Reconstr Surg 25 15 Occurrence Handle13851020

    PubMed  Google Scholar 

  6. 6.

    J Karnes W Morrison M Salisbury M Schaeferle P Beckham RA Ersek (2000) ArticleTitleSimultaneous breast augmentation and lift Aesth Plast Surg 2 148 Occurrence Handle10.1007/s002660010024

    Article  Google Scholar 

  7. 7.

    JQ Owsley SuffixJr (1975) ArticleTitleSimultaneous mastopexy and augmentation for correction of the small, ptotic breast Ann Plast Surg . 2

    Google Scholar 

  8. 8.

    MM Persoff (2003) ArticleTitleVertical mastopexy with expansion augmentation Aesth Plast Surg 27 13 Occurrence Handle10.1007/s00266-002-0072-8 Occurrence Handle1:STN:280:DC%2BD3s3mtVKgsw%3D%3D

    Article  CAS  Google Scholar 

  9. 9.

    CL Puckett VH Meyer JF Reinisch (1985) ArticleTitleCrescent mastopexy and augmentation Plast Reconstr Surg 75 533

    Google Scholar 

  10. 10.

    P Regnault (1976) ArticleTitleBreast ptosis: Definition and treatment Clinl Plast Surg . 3

    Google Scholar 

  11. 11.

    P Regnault (1966) ArticleTitleThe hypoplastic and ptotic breast: A combined operation with prosthetic augmentation Plast Reconstr Surg 37 31 Occurrence Handle1:STN:280:CCmD2sjmvFQ%3D Occurrence Handle5903218

    CAS  PubMed  Google Scholar 

  12. 12.

    SL Spear (2003) ArticleTitleAugmentation/mastopexy: “Surgeon, beware.” Plast Reconstr Surg 112 905 Occurrence Handle10.1097/01.PRS.0000072257.66189.3E Occurrence Handle12960875

    Article  PubMed  Google Scholar 

  13. 13.

    SL Spear M Beckenstein (1998) Periareolar approach to augmentation mastopexy SL Spear (Eds) Surgery of the breast: Principles and art Lippincott-Raven Philadelphia

    Google Scholar 

  14. 14.

    SL Spear SP Davison (2000) ArticleTitleBreast augmentation with periareolar mastopexy Oper Tech Plast Reconstr Surg 7 131

    Google Scholar 

  15. 15.

    SL Spear SY Giese (2000) ArticleTitleSimultaneous breast augmentation and mastopexy Aesth Surg J 20 155 Occurrence Handle10.1067/maj.2000.106474

    Article  Google Scholar 

  16. 16.

    SL Spear SY Giese I Ducic (2001) ArticleTitleConcentric mastopexy revisited Plast Reconstr Surg 107 1294 Occurrence Handle10.1097/00006534-200104150-00032 Occurrence Handle1:STN:280:DC%2BD3M3osleltA%3D%3D Occurrence Handle11373576

    Article  CAS  PubMed  Google Scholar 

  17. 17.

    SL Spear M Kassan JW Little (1990) ArticleTitleGuidelines in concentric mastopexy Plast Reconstr Suref 85 961 Occurrence Handle1:STN:280:By%2BB2s3ot10%3D

    CAS  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Scott L. Spear M.D..

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Spear, S.L., Pelletiere, C.V. & Menon, N. One-Stage Augmentation Combined with Mastopexy: Aesthetic Results and Patient Satisfaction. Aesth Plast Surg 28, 259–267 (2004).

Download citation


  • Augmentation
  • Mastopexy
  • Breast augmentation