SINGLE STAGED MASTOPEXY WITH AUTOLOGOUS FAT GRAFTING
Kamran Khoobehi MD, Alireza Sadeghi MD
Abstract:
Background: Numerous techniques for correction of mammary ptosis have been described.
However, the majority of women requiring mastopexy require some degree of volume
augmentation to compensate for mammary atrophy. The concept of a single stage mastopexy
with prosthetic implant augmentation is an attractive concept, but is known to have higher rates of
complications and frequent need for revisions. Furthermore, superior pole fullness is usually
lacking in majority of patients undergoing this procedure and postoperative "bottoming out" of the
implant is a common long term problem. Utilizing autologous fat grafting as a means of
augmenting volume, creating an attractive cleavage and providing superior pole fullness to the
breasts at the time of mastopexy is a viable alternative.
Methods: A retrospective review of 89 autologous fat transfers to the breasts in 46 patients from
October 2006 to March 2009 was performed. Procedures included mastopexy and autologous fat
grafting with or without implant removal. Pre- and postoperative photography and mammography
were performed.
Results: The mean follow-up period of patients was 12.5 months. With the exception of one
patient, all patients with postoperative mammograms were clear of any abnormalities in
comparison to preoperative mammograms. All women had a significant improvement in their
breast size and shape postoperatively and all had breasts that were soft and natural in feel and
appearance without evidence of fat necrosis (Figure 1). Mean operative time of mastopexy and
fat grafting to the breast was 154.7 minutes (Table 1).
Conclusion: Single staged mastopexy with autologous fat grafting to correct breast ptosis with
restoration of volume is an alternative in breast rejuvenation. This single staged technique
provides superior pole fullness of the breast and an attractive cleavage without disturbing the
circulation to the breast and the architecture of the breast. Therefore, by eliminating the use of
prosthesis it reduces the rates of complications seen with mastopexy and simultaneous implant
augmentation.
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DISCLOSURES: None of the authors has a financial interest in any of the products, devices, or
drugs mentioned in this manuscript
Figure 1. 30 year old female with a 9 month follow up after undergoing an abdominoplasty and
single staged mastopexy with autologous fat grafting of 710 cc to each breast.
Patient Demographics
Patients
Breasts
Mastopexy only
Mastopexy & Implant removal
Age (Mean)
BMI (Mean)
Operative Time (minutes)
Amount Fat Graft (cc)
Right Breast
Left Breast
Follow Up (months)
Grade of Ptosis
46
89
34
12
19 - 66 (39.6 ± 10.3)
19.5 - 35.4 (24.8 ± 4.0)
95 - 223 (154.7 ± 36.4)
172 - 780 (382.7 ± 138.1)
95 - 710 (391.1 ± 172.1)
1-29 (12.5 ± 7.6)
1-3 (2.4 ± 0.6)
Table 1. Patient Demographics and results pertaining to follow up, operative time and amount of
fat grafted to either breast.