Comparison between Augmentation Mastopexy in One Session and Two Separate Sessions

Abstract Background: Breast ptosis is a growing disfiguring and psychosocial problem which has gained greater attention recently. Moderate and sever degrees of breast ptosis is corrected surgically through augmentation-mastopexy opera-tion using breast implant to enhance the breast tissue and resection of excess skin. It is whiter done in one session or in two separate sessions; mastopexy followed by breast augmentation in second stage. The choice between the two technique has been a controversy since each has special challenges. Aim of Study: To draw a comparison between the two techniques in the treatment of 2nd and 3rd degree of breast ptosis, augmentation-mastopexy using silicone implants in one session versus in two separate sessions (mastopexy followed by breast augmentation in 2nd stage), regarding patient satisfaction, clinical outcome and complications in a period of 6 months post-operatively. Patients and Methods: This is a retrospective cohort study comparing the two techniques of augmentation-mastopexy regarding patient satisfaction and quality of life along with clinical outcome and complications. Two groups of 15 patients each; G1 having one stage and G2 having two stages augmen-tation-mastopexy. All cases were operated on in time period from 2015 to mid-2019 with mean follow-up time of 2.5 years in both groups and minimum of 6 months for each case. Results: G1 and G2 reached satisfaction about the breast after operation by 75% and 72% respectively with increase in satisfaction than before surgery by 55.47% and 56.27%, G1 was satisfied with outcome of operation by 82.47% vs. 78.47% in G2, psychosocial wellbeing increased by 66.07% in G1 vs. 54.54% in G2, physical wellbeing regarding breast area showed 0.07% decrease in G1 vs. decrease by 10.87% in G2 in form of pain and discomfort in chest and breast during exercise, sexual wellbeing and confidence in breast area and in front of partner were increased by 60.74% in G1 vs. 56.14% in G2, regarding clinical observation all cases of G1 was suffering from grade 2 ptosis, 2 cases of G2 were of grade 3 ptosis and the rest were of grade 2, all degrees of ptosis were corrected post operatively, no recurrence of ptosis in period extended to 6 months after operation, 13.3% of cases in G1 had wound infection vs. 6.67% in G2, 20% of cases in G1 had wound disruption vs. no disruption noticed in G2, scar widening reached up to 46.67% of cases in G2 (after 2nd stage) vs. 33.3% in G1, also capsular contracture happened in one case only of G2 by incidence of 6.66% vs. no incidence in cases of G1, no extrusion of implant in both groups. Conclusion: The study reveals that both techniques are effective in treatment of breast ptosis with no significant difference in patient satisfaction and clinical complications. And there is no added risk for combining the procedure; moreover, one stage technique excludes a 2nd operation. A more obvious comparative values between the two techniques and late post-operative complications and long-term results need to be determined by further studies on a larger scale of patients and longer duration of follow-up.