Abstract：
BACKGROUND: Despite high complication rates, patients persistently present for single-stage augmentation mastopexy. In empty, deflated breasts, we perform one-stage augmentation mastopexy; however, in heavy ptotic breasts, our preference is to stage the procedure with mastopexy and fat graft first. With volume from fat grafting focussing on the upper pole and cleavage areas, many of our patients avoid implants altogether. This reduces subsequent risks of waterfall deformity, implant displacement, rupture and a lifetime of implant exchanges.
OBJECTIVE: We aim to describe our findings and technique for reducing progression to the second stage of a two-stage augmentation mastopexy with the appropriate use of moderate to high volume of fat grafting at the primary operation.
METHODS: This is a retrospective review of all patients who presented to the senior author (KT) requesting breast implants and requiring mastopexy, from January 2018 to December 2022.
RESULTS: Over the five-year period, 137 patients were identified. Seventy-one (51.8%) underwent single-stage augmentation mastopexy, 55 (40.1%) underwent mastopexy with fat grafting and 11 (8.0%) underwent mastopexy with no fat grafting. Our key finding in this study is that 52 of 66 (78.8%) of planned staged patients, who underwent mastopexy with or without fat grafting, were happy with the volume attained and no longer wished to undergo further implant augmentation.
CONCLUSIONS: In selected patients, appropriate volume and position of fat grafting at the time of primary mastopexy can significantly obviate the need for a second stage implant (alloplastic) augmentation.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
OBJECTIVE: We aim to describe our findings and technique for reducing progression to the second stage of a two-stage augmentation mastopexy with the appropriate use of moderate to high volume of fat grafting at the primary operation.
METHODS: This is a retrospective review of all patients who presented to the senior author (KT) requesting breast implants and requiring mastopexy, from January 2018 to December 2022.
RESULTS: Over the five-year period, 137 patients were identified. Seventy-one (51.8%) underwent single-stage augmentation mastopexy, 55 (40.1%) underwent mastopexy with fat grafting and 11 (8.0%) underwent mastopexy with no fat grafting. Our key finding in this study is that 52 of 66 (78.8%) of planned staged patients, who underwent mastopexy with or without fat grafting, were happy with the volume attained and no longer wished to undergo further implant augmentation.
CONCLUSIONS: In selected patients, appropriate volume and position of fat grafting at the time of primary mastopexy can significantly obviate the need for a second stage implant (alloplastic) augmentation.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
摘要：
背景：尽管并发症发生率很高，患者持续出现单阶段增强乳房固定术。在空的，乳房放气，我们进行一阶段增强乳房固定术；然而，在沉重的乳房中，我们倾向于先进行乳房固定术和脂肪移植。脂肪移植的体积集中在上极和卵裂区域，我们的许多患者完全避免植入。这减少了瀑布畸形的后续风险，植入物位移,破裂和植入物交换的寿命。
目的：我们的目的是描述我们的发现和技术，以减少进展到第二阶段的两阶段增加乳房固定术，并在初次手术中适当使用中等至大量的脂肪移植。
方法：这是对所有向高级作者（KT）提出要求乳房植入物并需要乳房固定术的患者的回顾性研究，从2018年1月到2022年12月。
结果：在五年期间，确定了137名患者。七十一人(51.8%)接受了单阶段增强乳房固定术，55例（40.1％）进行了脂肪移植的乳房固定术，11例（8.0％）进行了无脂肪移植的乳房固定术。我们在这项研究中的关键发现是，66例计划分期患者中有52例（78.8％），接受乳房固定术有或没有脂肪移植的人，对获得的体积感到满意，不再希望进行进一步的植入物增强。
结论：在选定的患者中，在初次乳房固定术时，适当的脂肪移植体积和位置可以显着消除对第二阶段植入物（同种异体）增强的需要。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
目的：我们的目的是描述我们的发现和技术，以减少进展到第二阶段的两阶段增加乳房固定术，并在初次手术中适当使用中等至大量的脂肪移植。
方法：这是对所有向高级作者（KT）提出要求乳房植入物并需要乳房固定术的患者的回顾性研究，从2018年1月到2022年12月。
结果：在五年期间，确定了137名患者。七十一人(51.8%)接受了单阶段增强乳房固定术，55例（40.1％）进行了脂肪移植的乳房固定术，11例（8.0％）进行了无脂肪移植的乳房固定术。我们在这项研究中的关键发现是，66例计划分期患者中有52例（78.8％），接受乳房固定术有或没有脂肪移植的人，对获得的体积感到满意，不再希望进行进一步的植入物增强。
结论：在选定的患者中，在初次乳房固定术时，适当的脂肪移植体积和位置可以显着消除对第二阶段植入物（同种异体）增强的需要。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
