Periareolar augmentation mastopexy: A new approach dealing with the cases as tuberous breasts

ABSTRACT

Background: Periareolar augmentation mastopexy is one of the most demanded operations at Plastic Surgery clinics. Nevertheless, it is one of the leads of malpractice claims in United States caused by the high patient expectations and the standard surgical techniques which may result in common complications. The aim of this report is to present a new surgical approach to solve these complications. Methods: After establishing a working hypothesis, we performed a revision study of our patients and we came to the following conclusion: in order to perform a periareolar mastopexy for ptosis correction, breast has to be tuberous at any level and to have abnormally short inferior pole. These findings may explain the main complications from periareolar augmentation mastopexy with the standard surgical techniques. Consequently, we started a prospective observational study including 56 patients following a new surgical technique which deals the cases as tuberous breasts. Results: During three years, fifty-six periareolar mastopexies were performed with this new surgical approach with one year follow-up. No major complications were observed and 40 of the patients (71%) described the results as very positive. Conclusion: “If a periareolar mastopexy can be performed, then it must be a tuberous breast”. According to this, a new surgical technique for periareolar augmentation mastopexy has been developed obtaining an improvement in our surgical results and achieving a totally different view on this pathology, which has not been reported in literature yet.

KEY WORDS

Aesthetic breast surgery - anomalies - breast base - periareolar mastopexy - ptosis - tuberous breast

 

Conflicts of interest

There are no conflicts of interest.

• REFERENCES

• 1 Reisman NR. Medico-legal issues in plastic surgery. In: Neligan PC. editor. Plastic Surgery. 3rd ed.. Vol. 1 Seattle, Washington: Elsevier; 2013. Chapter 6, p. 92-103
• 2 Tebbetts JB. editor. Augmentation mastopexy. In: Augmentation Mammaplasty. Redefining the Patient and Surgeon Experience. 1st ed. Elsevier; 2010. Chapter 20. p. 501-51
• 3 Higdon K, Grotting J. Mastomexy. In: Plastic Surgery. Seattle, Washington: 3rd ed.. Vol. 5 Elsevier; 2013. Chapter 7, p. 119-51
• 4 Benelli LC. Periareolar benelli mastopexy and reduction. In: Spear SL. editor. Surgery of the Breast: Principles and Art. Philadelphia: Lippincott-Raven; 1998: p. 685
• 5 Maxwell GP, Gabril A. Mastopexy augmentation. In: Bucky LP. editor. Aesthetic Breast Surgery. 1st Ed. Philadelphia: Saunders Elsevier; 2009. Chapter 11, p. 153-66
• 6 Spear SL, Giese SY, Ducic I. Concentric mastopexy revisited. Plast Reconstr Surg 2001; Apr 15; 107 (05) 1294-9
• 7 Hammond DC. editor. Mastopexy. In: Atlas of Aesthetic Breast Surgery. 1st ed. Michigan: Saunders Elsevier; 2009: p. 82-128
• 8 Penn J. Breast reduction. Br J Plast Surg 1955; 7: 357-71
• 9 Liu YJ, Thomson JG. Ideal anthropomorphic values of the female breast: Correlation of pluralistic aesthetic evaluations with objective measurements. Ann Plast Surg 2011; 67: 7-11
• 10 Tebbetts JB. Dual plane breast augmentation: Optimizing implant-soft-tissue relationships in a wide range of breast types. Plast Reconstr Surg 2001; 107: 1255-72
• 11 DeLuca-Pytell DM, Piazza RC, Holding JC, Snyder 4th N, Hunsicker LM, Philips LG. The incidence of tuberous breast deformity in asymmetric and symmetric mammaplasty patients. In: Shiffman MA. editor. Breast Augmentation. 1st ed. Berlin: Springer Berlin Heidelberg; 2009: p. 301-6
• 12 Serra-Renom JM, Muñoz-Olmo J, Serra-Mestre JM. Treatment of grade 3 tuberous breasts with Puckett's technique (modified) and fat grafting to correct the constricting ring. Aesthetic Plast Surg 2011; 35: 773-81
• 13 Grolleau JL, Lanfrey E, Lavigne B, Chavoin JP, Costagliola M. Breast base anomalies: Treatment strategy for tuberous breasts, minor deformities, and asymmetry. Plast Reconstr Surg 1999; 104: 2040-8
• 14 Palacín Casal JM. Mamoplastia transversal en mamas tuberosas. Cir Plast Iber Lat Am 2011; 37: 205-14