Safety of Augmentation Mastopexy in a Teaching Environment: Complication Analysis

Abstract Background Breast hypoplasia and ptosis, whether congenital or acquired, may significantly affect body image and quality of life. Augmentation mastopexy is an effective corrective procedure but is technically demanding and associated with a recognized risk of complications, raising concerns regarding its role in surgical training. Objectives The aim of this study was to evaluate the incidence and type of complications following augmentation mastopexy performed by plastic surgery residents under direct attending supervision and to assess the implications for training within an academic setting. Methods A retrospective analysis was conducted of 289 consecutive augmentation mastopexy procedures performed between January 2020 and January 2024, with a minimum follow-up of 12 months. All procedures were performed by residents under the continuous supervision of experienced plastic surgeons. Data regarding patient characteristics, surgical technique, implant selection, and postoperative complications were collected and analyzed. Results Forty-six complications were recorded, corresponding to an overall complication rate of 15.9%. Minor complications included suture dehiscence (4.84%), secondary ptosis (3.4%), asymmetry (3.11%), hematoma (1.3%), and seroma (1.3%). Major complications included capsular contracture (0.7%) and infection (1.0%). Reoperations were primarily required for major complications or patient-reported aesthetic dissatisfaction. Overall outcomes were comparable to those reported in the literature. Conclusions Within a structured academic program with direct attending supervision, augmentation mastopexy can be safely performed by residents, achieving complication rates comparable to published data. These findings support the role of supervised augmentation mastopexy as a valuable component of plastic surgery training. Level of Evidence: 4 (Risk)