Augmentation Mastopexy With Polyurethane-Coated Implants in the Prepectoral Plane: A 24-Month Follow-Up Study.

BACKGROUND: Augmentation mastopexy aims to restore breast shape and volume in patients with ptosis. Polyurethane-coated implants may enhance implant stability in augmentation mastopexy through early tissue adhesion in the prepectoral plane; however, mid-term stability and clinical outcomes remain incompletely defined, prompting the need for the present study. OBJECTIVES: The aim of this study was to evaluate the long-term aesthetic stability, complication profile, and patient satisfaction associated with augmentation mastopexy using polyurethane-coated implants placed in the prepectoral plane, with or without selective fat grafting. METHODS: From January 2019 to December 2023, 169 patients (338 breasts) underwent augmentation mastopexy with polyurethane-coated implants placed in the prepectoral plane. The surgical protocol included mastopexy, implant placement, and selective fat grafting, when needed, to optimize breast contour in patients with asymmetries or minimal soft-tissue coverage (eg, pinch test <2 cm). Patients were followed up at 1, 6, 12, 18, and 24 months postoperatively, with the primary endpoint being the nipple-to-jugular distance (NJD), used to assess breast stability. Patient satisfaction was assessed using a 5-point Likert scale at 12 months. RESULTS: The average preoperative NJD was 27.4 cm, and postoperatively, a significant reduction was observed at 1 month (21.5 cm), with minimal increase over time (22.3 cm at 24 months), indicating stable breast positioning. A single case of capsular contracture was managed with implant replacement. Patient satisfaction was high, with 78% rating their results as "very satisfied" (Score 5). CONCLUSIONS: Augmentation mastopexy with polyurethane-coated implants placed in the prepectoral plane provides stable, long-term breast positioning and high patient satisfaction. This technique offers a reliable alternative to traditional approaches, with minimal complications and sustained aesthetic results. LEVEL OF EVIDENCE 4 THERAPEUTIC: For image description, please refer to the figure legend and surrounding text.