Systematic Review: Periareolar Mastopexy with Breast Implants and Fat Grafting

Background: Periareolar mastopexy (PM) is a widely used technique for breast lift surgery, often combined with implants to improve breast volume. In recent years, autologous fat grafting (FG) has emerged as an adjunct to PM, enhancing contour and soft tissue volume. Objectives: This article aimed to assess the complication rate, patient satisfaction, aesthetic outcomes, and long-term PM results combined with breast implants (BI) and FG. Methods: A systematic review was performed using PubMed, MEDLINE, Web of Science, Embase, PreMEDLINE, EBase, CINAHL, Clinicaltrials.gov, Scopus, and Cochrane databases. The protocol was developed following the Preferred Reporting for Items for Systematic Reviews-Protocols (PRISMA-P) guidelines. The included studies had to match predetermined criteria according to the PICOS approach. Results: A total of 13 studies with 1165 patients were included. The results showed a significant improvement in patient satisfaction, with 85% of patients reporting high satisfaction levels. The complication rate was relatively low, with capsular contracture (7.3%), fat absorption (9.7%), and wound healing issues (4.9%) being the most common. Aesthetic outcomes, measured by breast symmetry and shape, showed favorable results in 78.2% of patients. The combination of PM with BI and FG improved the breast’s volume and contour, providing a more natural outcome than BI alone. Conclusions: PM with BI and FG appears to be a safe and effective procedure for enhancing breast aesthetics. The combination of these techniques offers significant improvements in patient satisfaction and aesthetic outcomes with acceptable complication rates. Further large-scale randomized controlled trials are needed to confirm these findings and establish long-term safety profiles. Level of Evidence I: Evidence from a systematic review of all relevant controlled trials. 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.