Ptosis + volume loss is the classic “deflated upper pole in a stretched envelope” problem—and mastopexy-augmentation is where planning mistakes become revisions. This episode breaks down how to choose the right mastopexy pattern, when augmentation alone is enough, and the technical pitfalls that drive complications (especially scarring, malposition, and ischemic risk).

We’ll walk through ptosis classification (Regnault), a nipple elevation + desired volume algorithm, and the practical tradeoffs between circumareolar, vertical (circumvertical), and Wise-pattern approaches. You’ll also get a clean framework for deciding one-stage vs staged augmentation-mastopexy, plus what to watch for in secondary cases (prior pedicles, thinning tissues, capsular work, “snoopy” and “ball-in-sock” deformities).

Key takeaways (resident-focused):

• Match technique to required nipple elevation and volume goal—not scar preference.

• Minimize undermining to protect NAC + skin flap perfusion.

• Conservative skin markings in aug-mastopexy: implants change nipple-to-fold geometry.

• One-stage is reasonable in good candidates; high-risk patients should usually stage.

• Revision drivers are often scar-related, not the “pattern” itself.

Disclaimer: This content is for educational purposes only and is not medical advice.

#PlasticSurgery #Mastopexy #BreastAugmentation #AestheticSurgery #PRS #Residency

Citations (AMA):

1. Regnault P. Breast ptosis. Definition and treatment. Clin Plast Surg. 1976;3(2):193-203.

2. Rohrich RJ, Thornton JF, Jakubietz RG, Jakubietz MG, Grunert JG. The limited scar mastopexy. Plast Reconstr Surg. 2004;114(6):1622-1630.

3. Spear SL, Dayan JH, Clemens MW. Augmentation mastopexy. Clin Plast Surg. 2009;36(1):105-115.

4. Stevens WG, Freeman ME, Stoker DA, Quardt SM, Cohen R, Hirsch EM. One-stage mastopexy with augmentation: 321 patients. Plast Reconstr Surg. 2007;120(6):1674-1679.

5. Stevens WG, Stoker DA, Freeman ME, Quardt SM, Hirsch EM. Mastopexy revisited: 150 cases. Aesthet Surg J. 2007;27(2):150-154.

   
   

   🎧 Full episodes available now:

   Instagram: https://www.instagram.com/plasticsinpractice/

   Spotify: https://open.spotify.com/show/4Ct8jOgYXP9QJin7QOuG3Z?si=JNcBxQmwT2mfz1LSJZEFKA

   Apple: https://podcasts.apple.com/us/podcast/plastics-in-practice-resident-review/id1835564216

   YouTube: https://youtube.com/@plasticsinpractice?si=tqLInp5vvsJFKlRO

   Amazon: https://music.amazon.com/podcasts/8bef056e-7c87-4224-978e-7e691b04554a/

   📘 Free Study Guides: → https://drive.google.com/drive/u/0/folders/12BUldPbCmihG-ndZh6992WqhRYyxw8ZZ