Unsatisfactory Results of Periareolar Mastopexy With or Without Augmentation and Reduction Mammoplasty: Enlarged Areola With Flattened Nipple

Abstract

A method of repair is described for correction of abnormally enlarged nipple-areola complex following both periareolar mastopexy and pregnancy. Although during periolar mastopexy or reduction mammoplasty regular subcuticular dermal sutures may control the enlargement of nipple-areola complexes initially, the periareolar scar becomes hypertrophic and areolar spreading occurs to some extent. Periareolar mastopexy techniques are indeed advisable only for minimal hypertrophies or ptosis of the breast, especially for areolar asymmetry, if an acceptable, normal-size areola is expected. The authors believe that in periolar mastopexy or reduction mammoplasty cases resulting in enlarged nipple-areola complexes, the size of the areola can also be corrected by reduction mammoplasty or mastopexy using vertical bipedicle techniques. Although surgery results in an inverted T incision, the shape of the breast is more acceptable and the size of the areola does not enlarge with time.

Secondary Augmentation-Mastopexy: Indications, Preferred Practices, and the Treatment of Complications

“…However, we prefer circumareolar mastopexies because these patterns produce more acceptable scarring. 25,[38][39][40][41] …”

Augmentation Mastopexy

“…17 In the vast majority of cases, a circumareolar or, more commonly, a vertical or circumvertical technique is sufficient, leaving a formal ''Wise'' pattern for only the most severe cases. A circumareolar mastopexy alone works well only for the patient in whom the nipple lies near or just below the fold with the inferior border of the areola no lower than the inferior curve of the breast on frontal view, and when there is less than 4 cm of breast overhanging the fold, leaving an initial nipple-tofold distance of no more than 8 to 9 cm.…”

Breast Augmentation and Mastopexy: How to Select and Perform the Techniques Minimizing Complications

“…It is true that the combination of both procedures is more laborious and detailed than either of the two done separately [8,9,11,13,15], and so the author's recommendations are focused on three aspects: follow the parameters for properly choosing the technique to be used [6,[10][11][12], perform the surgery correctly [6,[10][11][12], and know the reason for the complications and how to maximize avoidance of them. With this in mind, mastopexy with implants at the same surgical time should be considered totally feasible, without major complications from having combined the two procedures at the same surgical time.…”

“…Th e relevant thing about the combination of these two procedures at the same surgical time is that opinions regarding the benefi t or diffi culty and incidence of complications are quite diverse. While some authors say that performing mastopexy and augmentation is a procedure that gives very good results, and that the incidence of complications is low [10][11][12], other studies state that it is a high-risk procedure with a greater number of complications than if the two surgeries were performed separately [8,9,[13][14][15]. Th e authors who report a greater incidence of complications even warn that in some cases these complications can be severe and deforming [15].…”