Although a single stage breast augmentation procedure is preferable to the surgeon and patient, sometimes a breast augmentation alone will not give the desired result and an uplift of the breast tissue (mastopexy) is required. Breast augmentation/mastopexy when performed in a single stage presents more significant challenges than either augmentation or mastopexy alone. The combination of breast augmentation and mastopexy in one surgery increases the risk of complications than either surgery carries alone.
After breastfeeding or weight loss (or for other reasons), the natural breast tissue can descend on the chest wall. The main reason for a breast lift is to raise the position of downward pointing nipples, areolas and breast tissue. IMPLANTS ALONE WILL NOT RAISE THE POSITION OF THE BREAST OR NIPPLE SIGNIFICANTLY. Therefore if a patient presents with a saggy breast, an aesthetically pleasing result cannot be achieved without the repositioning of the nipple and breast tissue. If breast enlargement and a more fuller upper pole look is also desired, then the insertion of implants should also be performed.
Performing the two procedures simultaneously is better for the patient for many reasons, not the least being the economic considerations of cost, discomfort and time off work and leisure. It is possible to perform breast enlargement and repositioning at the same time in the majority of patients, but these patients must accept that there may be a need for a further relatively minor corrective procedure if the ideal cosmetic outcome is to be achieved.
Reasons for revision were more tissue related rather than implant related and include areolar asymmetry, pseudoptosis with “bottoming-out”, breast asymmetry, recurrent and persistent ptosis, poor scarring and superficial nipple-areolar necrosis.
The secondary procedure would entail an adjustment of either the position of the implant or the position of the nipple and almost always is attended by minimal post-operative recovery and downtime. There would be additional surgical, anaesthetic and theatre fees, but these would always be less than if one planned two separate operations 4-6 months apart.