Single-stage Layered versus Nonlayered Mastopexy with Augmentation in Muscle Splitting Biplane: A Comparative Analysis

Abstract

Background: Single-stage layered mastopexy with augmentation is a modification of muscle-splitting pocket that reduces risk of complications and revision rate. Methods: A retrospective chart review of all the consecutive cases, performed by a single surgeon, from March 2007 to August 2019, was conducted. All patients had surgery with superomedial pedicle in an approved facility. The patients were divided into group A whose implants were placed through the mastopexy incision, and group B whose implants were placed first and access closed prior to mastopexy. Results: Nonlayered group A included 116 patients and layered group B included 102 patients. Groups A and B had a mean age of 32.3 + 9.70 and 34.8 + 10.39 years (range, 20–66), respectively (P value 0.070). In groups A and B, 95 (81.9%) and 74 (72.5%) patients underwent primary and 21 (18.1%) and 28 (27.5%) patients underwent secondary procedures, respectively (P value 0.099). There were no hematomas in group A and two patients had hematoma in group B (P value 0.218). In group A, one patient experienced periprosthetic infection with none in group B (P value 0.41). Wound breakdown was observed in ten (8.6%) patients in group A and four (3.9%) patients in group B (P value 0.128). In group A, there was a partial or complete nipple loss in two (1.7%) and none in group B (P value 0.412). In group A, 15 (12.9%) underwent revision surgery and six (6.5%) in group B (P value 0.127). Conclusion: Layered mastopexy with augmentation provides improved safety, fewer complications and revisions with adequate results.