In reality, the appearance of the breast after this treatment may be unsatisfactory, due to a number of factors. Lumpectomy may deform the breast, leaving unsightly and poorly planned scars in the upper visible quadrant. Scars from port placement for chemotherapy are often midway between the clavicle and the breast. Resection of lower-quadrant tumors may deform the nipple location, increasing the appearance of breast asymmetry.Radiation may cause soft-tissue contraction, skin discoloration, and scar-related exaggerated deformity. Reconstruction with an implant has one of the highest complication rates, severely affecting the result due to radiation. Reconstruction with well-vascularized flap tissue, such as a TRAM, is not immune to radiation damage, either. Women disappointed by their result then seek consultation regarding options for achieving a more aesthetically satisfactory result.
The FDA has reported that breast augmentation leads to an 18% to 22% rate of reoperation. The number of complications that can grow out of an augmentation-lift combination procedure makes informed consent a top priority for any woman interested in breast surgery.These risks from combination augmentation-mastopexy procedures include the following:Risk of breast implant exposure;Risk of infection; and,Risk of excessive scarring.
In 2004, Spear et al produced augmentation-mastopexy outcome data involving 34 patients over a 6-year period. Of the 34 patients, 41% had grade 1 ptosis, 41% had grade 2 ptosis, 3% had grade 3 ptosis, and 12% had grade 4 ptosis.
With 50% of the participants responding, 54% desired revision surgery with an expressed desire for a greater lift of the breasts.