Explantation Combined with Lollipop Incision Mastopexy after Unsatisfactory Breast Augmentation: A Reliable Surgical Approach

Background: Although breast augmentation for ptosis correction has significant advantages and achieves favorable outcomes in specific indications, for patients with large breast volume or significant ptosis, implant alone often fails to provide adequate lift and may worsen the degree of ptosis. This study summarizes the clinical experience and key points of our institution in performing secondary mastopexy via the lollipop incision technique. Methods: This was a single-center retrospective study that included patients who underwent explantation combined with lollipop incision mastopexy after unsatisfactory breast augmentation from October 2019 to October 2024. The analysis included baseline demographic data, breast ptosis correction assessment parameters, and BREAST-Q domain scores. At the final follow-up, corrective outcomes, aesthetic results, and patient satisfaction were evaluated. Results: Twenty-three patients underwent secondary mastopexy for correction. Postoperatively, the distance from the nipple to the inframammary fold (N-IMF), the distance from the sternal notch to the nipple (S-N), the distance from the clavicle to the nipple (C-N), and the base width of the breast (BW) all decreased significantly (all P < 0.001), resulting in successful ptosis correction in every case. Moreover, BREAST-Q assessments demonstrated significant improvement over preoperative scores, including satisfaction with breasts ( P < 0.001), psychosocial well-being ( P < 0.001), physical well-being: chest ( P = 0.002), and sexual well-being ( P = 0.007). Conclusions: Our results demonstrate that secondary mastopexy using the explantation combined with lollipop incision technique is a reliable approach for managing failed breast augmentation in the correction of ptosis. Patients who required glandular reshaping and skin redraping achieved good aesthetic outcomes. Clinical question/level of evidence: Therapeutic, IV Trial registration: ChiCTR2500097610