Augmentation Mastopexy Techniques
Single-Stage vs Two-Stage Approach
The most important decision in augmentation mastopexy is whether to perform the combined procedure in a single operation or in two separate stages. A single-stage procedure is appropriate for patients with mild to moderate ptosis, good skin quality, and a modest implant volume requirement — where the competing tensions of implant and mastopexy closure can be safely balanced. A two-stage approach — mastopexy first, augmentation 3–6 months later once the tissues have healed — is recommended where ptosis is more severe, skin quality is poor, or where the desired implant volume would create excessive tension on the closure. Mr Nassab will assess which approach is most appropriate at your consultation.
Mastopexy Technique Selection
The mastopexy component is selected based on the degree of ptosis. A periareolar (Benelli) lift — scar around the areola only — is suitable for minimal ptosis and minor skin excess. A vertical (lollipop) mastopexy — scar around the areola and vertically to the breast crease — is the most commonly used technique for moderate ptosis and is Mr Nassab's preferred approach where anatomy allows. A Wise pattern (anchor) mastopexy — adding a horizontal scar along the breast crease — is used for more significant ptosis requiring greater skin removal and reshaping.
Implant Placement & Selection
The implant is typically placed in a dual-plane or sub-muscular position, which provides additional tissue coverage over the implant and reduces the risk of visible implant edges or rippling — particularly important when the breast tissue is thin following deflation. Implant volume is carefully calibrated: overly large implants create excessive tension on the mastopexy closure, increasing complication risk and the likelihood of recurrent drooping over time. Mr Nassab uses premium Motiva Preservé and CE-marked implants, selected to achieve a natural, proportionate result.
Nipple-Areola Repositioning
The nipple-areola complex is repositioned to a higher, more central position on the breast mound as part of the mastopexy component. The areola may also be reduced in size where it has stretched. Nipple blood supply and, in most cases, sensation are preserved through careful pedicle design. The specific technique used to preserve the nipple pedicle is discussed at your consultation.
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