Perspective Chapter: Mastopexy/Augmentation and Revision Aesthetic Breast Surgery

Breast enhancement remains one of the most frequently performed procedures in aesthetic surgery, with patients pursuing a variety of techniques to improve the shape, contour, and overall appearance of the breasts. Augmentation-mastopexy, which simultaneously corrects glandular hypoplasia or hyperplasia as well ptosis, is an essential but complex technique within a cosmetic surgeon’s skill set. Achieving optimal outcomes requires careful consideration of multiple anatomical and aesthetic factors, including desired implant volume, existing breast dimensions, symmetry, nipple-areolar complex (NAC) size and placement, inframammary fold (IMF) position, and the thoracic contour. Combining mastopexy with augmentation presents technical challenges due to the contrasting objectives: mastopexy aims to tighten and elevate the breast, while augmentation involves expanding the tissue to enhance volume. These conflicting goals can complicate tissue management, vascular integrity, and implant positioning. Even with detailed preoperative planning, some cases may result in suboptimal outcomes. Potential complications include asymmetry, implant displacement, rupture, surface rippling, and capsular contracture. Addressing these issues through revision surgery demands advanced surgical acumen and experience, as it involves restoring harmony, contour, and patient satisfaction in a highly individualized manner.