Autoaugmentation versus Implant-Based Augmentation Mastopexy after Massive Weight Loss: Quality-of-Life, Surgical, and Aesthetic Results

Background: The rising incidence of massive weight loss (MWL) in women has led to an increased demand for breast surgery. Autoaugmentation and implant-based augmentation mastopexy represent well-established procedures in this patient population. However, there is a notable lack of direct comparison of these 2 surgical approaches in the current literature. Methods: This retrospective study included 100 consecutive patients with MWL over the past 7.6 years (64 autoaugmentation and 36 implant-based). Complication and surgical revision rates were collected retrospectively. During a follow-up examination, postoperative BREAST-Q scores, 36-item Short Form Health Survey scores, and aesthetic outcomes were evaluated. Results: The included patients had a mean age of 39 ± 10.6 years and a median follow-up time of 2.8 years (range, 0.3 to 7.6 years). In the autoaugmentation group, most aesthetic evaluation criteria and postoperative BREAST-Q scores for Satisfaction with Breasts ( P < 0.001) and Satisfaction with Outcome ( P < 0.001) were significantly higher. According to Clavien-Dindo classification, complications in the autoaugmentation group were mainly managed conservatively, whereas most complications in the implant group required surgical revision ( P = 0.009). Recurrent ptosis occurred more frequently in the implant group. The 36-item Short Form Health Survey results indicated no significant group differences. Conclusions: A tendency toward increased use of autoaugmentation techniques among 100 patients with MWL was observed, achieving significantly higher outcome scores and lower complication rates. If sufficient breast tissue is available, implant use should be avoided in this patient population. If an implant is required, patients should be thoroughly informed about the higher complication rates and potential need for revision surgery.