Augmentation Mastopexy

Extract

Dr. Gorney: Of all the liability claims filed after aesthetic surgical procedures performed in the United States in 2004, more than 60% involved the female breast. Although I don't have data specifying combination procedures, I believe that the number of cases involving mastopexy with augmentation is increasing. Augmentation mastopexy is a challenging operation about which there are a variety of opinions, including those held among our panelists. Let's begin with our first patient, a 32-year-old woman with 2 children, ages 4 and 7, that she breast fed for 3 months. She is presently an A to B bra cup size and desires a breast lift and larger breasts (Figure 1). Dr. Spear, how would you approach her treatment?

Dr. Spear: First, she has, in my view, a variant of a tuberous breast. Second, she is asymmetric. My plan would either be to leave the asymmetry as is, or to perform asymmetric procedures to improve her symmetry. When I evaluate patients for augmentation with mastopexy, I start by determining what the nipple-to-fold relationship is, how much the nipple hangs below the fold, and how much the breast overhangs the fold. Judging from the photograph, it appears that her left nipple sits roughly at the fold with a little bit of glandular ptosis, and the right nipple sits just over the fold with even more glandular ptosis.