Download PDF
Semin Plast Surg 2015; 29(02): 085-093
DOI: 10.1055/s-0035-1549049
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Delay Fill Technique: A Safer Approach to Combination Augmentation Mastopexy

Christopher K. Patronella
1   Department of Plastic Surgery, University of Texas Medical Branch, Galveston, Texas
,
Henry A. Mentz
2   The Aesthetic Center for Plastic Surgery, Houston Texas
,
Jaclyn Johnson-Alviza
3   Department of Plastic and Reconstructive Surgery, MD Anderson Cancer Center, Houston, Texas
› Author Affiliations
Further Information

Publication History

Publication Date:
16 April 2015 (online)

    Permissions and Reprints

Abstract

Combining breast augmentation with mastopexy is a challenging procedure that has a relatively high revision rate in the literature. Some surgeons prefer a two-stage procedure to avoid the potential for skin flap or nipple–areolar complex necrosis that can occur with a one-stage procedure. The authors compared 101 patients who had subpectoral breast augmentation with immediate implant fill and mastopexy with 203 patients who had subpectoral breast augmentation with delayed (10–14 days) implant fill and mastopexy. They found the revision rate for immediate implant fill was 24%; in the delayed implant fill group, the revision rate was 10.3%. Patients had soft tissue-related complications in 16% of the immediate fill group and in 2% of the delayed fill group. Delaying implant fill in combined breast augmentation mastopexy significantly reduces the risk of soft tissue-related complications and revision procedures; the delay flap phenomenon is responsible for fewer wound-healing complications when implant fill is delayed during a combined augmentation mastopexy procedure.

Keywords

augmentation mastopexy - delayed implant fill - breast revision
 

  • References

  • 1 Handel N. Secondary mastopexy in the augmented patient: a recipe for disaster. Plast Reconstr Surg 2006; 118 (7, Suppl): 152S-163S , discussion 164S–165S, 166S–167S
    CrossrefPubMedGoogle Scholar
  • 2 Spear SL. Augmentation/mastopexy: “surgeon beware.”. Plast Reconstr Surg 2003; 112: 905-906
    CrossrefPubMedGoogle Scholar
  • 3 Spear SL, Dayan JH, Clemens MW. Augmentation mastopexy. Clin Plast Surg 2009; 36 (1) 105-115 , vii, discussion 117
    CrossrefPubMedGoogle Scholar
  • 4 Mentz H, Patronella C, Ruiz-Razura A, Newall G, Boynton J, Siarski J. Salvage strategy for a compromised nipple areolar complex during augmentation mastopexy. Paper presented at Annual Meeting of the Texas Society of Plastic Surgeons; September 29, 2007;Bastrop, TX
    PubMedGoogle Scholar
  • 5 Spear SL, Boehmler IV JH, Clemens MW. Augmentation/mastopexy: a 3-year review of a single surgeon's practice. Plast Reconstr Surg 2006; 118 (7, Suppl): 136S-147S , discussion 148S–149S, 150S–151S
    CrossrefPubMedGoogle Scholar
  • 6 Stevens WG, Freeman ME, Stoker DA, Quardt SM, Cohen R, Hirsch EM. One-stage mastopexy with breast augmentation: a review of 321 patients. Plast Reconstr Surg 2007; 120 (6) 1674-1679
    CrossrefPubMedGoogle Scholar
  • 7 Stevens WG, Macias LH, Spring M, Stoker DA, Chacón CO, Eberlin SA. One-stage augmentation mastopexy: a review of 1192 simultaneous breast augmentation and mastopexy procedures in 615 consecutive patients. Aesthet Surg J 2014; 34 (5) 723-732
    CrossrefPubMedGoogle Scholar
  • 8 Gorney M, Maxwell PG, Spear SL. Augmentation mastopexy. Aesthet Surg J 2005; 25 (3) 275-284
    CrossrefPubMedGoogle Scholar
  • 9 Nahai F, Fisher J, Maxwell PG, Mills II DC. Augmentation mastopexy: to stage or not. Aesthet Surg J 2007; 27 (3) 297-305
    CrossrefPubMedGoogle Scholar
  • 10 Standring S, Borley NR, Collins P , et al , Eds. Gray's Anatomy: The Anatomical Basis of Clinical Practice. 40th ed. Philadelphia: Elsevier; 2008
    Google Scholar
  • 11 Lejour M. Vertical mammoplasty and liposuction of the breast. St. Louis, MO: Quality Medical Publishing; 1994: 49-52
    Google Scholar
  • 12 Georgiade NG, Georgiade GS, Riefkohl R, McCarty Jr KS, Carpenter SA, Georgiade GS. The breast: embryology, anatomy, and physiology. In: Georgiade NG, Georgiade GS, Riefkohl R, , eds. Aesthetic Surgery of the Breast. Philadelphia: WB Saunders; 1990: 3-17
    Google Scholar
  • 13 Bostwick J. Anatomy and physiology. In: Plastic and Reconstructive Breast Surgery. St. Louis, MO: Quality Medical Publishing; 2000: 77-123
    Google Scholar
  • 14 Local incisions and flap coverage. In: McCarthy JG, Littler JW, Little JW. , eds. Plastic Surgery: The Hand Part 1. Vol. 7. Philadelphia, PA: WB Saunders; 1990: 4451-4452
    Google Scholar
  • 15 Pitzer GB, Patel KG. Proper Care of Early Wounds to Optimize Healing and Prevent Complications. In: Mobley SR, , ed. Facial Plastic Surgery Clinics of North America. Philadelphia, PA: WB Saunders; 2011. 19(3): 491-504
    Google Scholar
  • 16 Gantwerker EA, Horn DB. Skin: histology and physiology of wound healing. In: Mobley SR, , ed. Facial Plastic Surgery Clinics of North America. Philadelphia, PA: WB Saunders; 2011. 19(3): 491-504
    Google Scholar
  • 17 Scallan J, Huxley VH, Korthuis RJ. Capillary Fluid Exchange: Regulation, Function, and Pathology. San Rafael, CA: Morgan and Claypool Life Sciences; 2010. . Chapter 4 Pathophysiology of Edema Formation
    Google Scholar