Augmentation-mastopexy using an autologous parenchymal sling

Background: Mastopexy-augmentation is an important treatment to address breast deflation. Combining these two procedures is technique-sensitive, with a reported high revision rate and propensity for complications. We describe an approach to achieve aesthetic breast correction in an effective, reproducible, and safe manner while minimizing untoward sequela. Methods: A vertical mastopexy, using a superior dermoglandular pedicle, is coupled with a subpectoral breast implant with the support of a longitudinal autologous sling of breast fascia, termed autologous sling augmentation-mastopexy. Results: Twenty consecutive patients, aged 25-49 years, were treated by this technique, with a follow-up period of at least 1 year. Aesthetic improvement of breast shape, projection, and nipple position were achieved in all patients. No major complications, including infection, necrosis, or implant exposure, occurred. Minor wound-healing deficits at the inferior aspect of the vertical resection occurred in three patients. One patient required implant exchange early postoperatively because of saline leakage. No revisions were necessary to adjust breast symmetry or nipple position. Conclusion: We describe a mastopexy-augmentation technique, based on patient selection, mastopexy resection pattern, and implant size and position, to improve breast aesthetics safely and reproducibly while minimizing complications and the need for near-term revision.