Double Space Augmentation Mastopexy—A Reflection After 15 Years

The treatment of breast ptosis using mastopexy associated with the inclusion of a silicone prosthesis in a single surgical procedure is a challenge for surgeons. The aim of this study is to describe the 15-year experience with the placement of silicone breast implants in double, subfascial and submuscular space, in the treatment of patients with breast ptosis, and to analyze the aesthetic results of patients who underwent such surgeries. During the 15-year period, between 2005 and 2020, 640 mastopexies were performed with the inclusion of silicone breast implants in double space, with high-profile round polyurethane prostheses whose volumes ranged from 135 to 435 ml, in patients with grade 2 and 3 breast ptosis. The age of the patients ranged from 18 to 55 years and the average age was 34 years. The postoperative follow-up time was 18 months. 400 patients (62.5%) had grade II ptosis, whereas 240 of them (37.5%) had grade III ptosis. The main complications were: 19 cases (3%) of residual sagging skin, 19 cases (3%) of unsightly scars, 12 cases (2%) of partial areola necrosis. There was no case of infection or seroma. There were 330 primary surgeries (52%) and 310 secondary surgeries (48%). After 15 years of performing mastopexy with prosthesis in double space, both in primary and secondary surgeries, it can be concluded that the technique reached its maturity providing good long-term results with the maintenance of the projection of the upper pole of the breast and low recurrence of ptosis in the lower pole and low rate of complications. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266