Autoaugmentation Mastopexy Modification Prevents Bottoming-Out Deformity and Areola Distortion: A Preliminary Report.

backgroundPtotic breast deformity results from involution of breast parenchyma and leads to a loss of volume, along with a converse laxity of the skin envelope. As the breast tissue descends inferiorly with gravity, there is an apparent volume loss in the upper pole and the central breast, and the lower pole becomes fuller and often wider. This study presents modifications for a well-known mastopexy technique which provides not only autoaugmentation for the breast but also suspension for the breast parenchyma and reduces bottoming-out deformity, and also obtains a regular areola shape in all types of breasts. PATIENTS AND

methodsThe modifications involve 2-4 cm subareolar crescentic incisions for regular areolas and cylindrical excision of the recipient area in the superior medial and lateral pillars for wide flaps in medium and large-size breasts.

resultsThe present study included 63 female patients, with an average body mass index of 25.5 ± 2.0 kg/m(2), aged 26-47 years (average 35 years). The author performed vertical scar mastopexy and augmented the breasts with a distal-based flap of deepithelialized dermoglandular tissue inserted beneath the breast parenchyma of a superior-based nipple-areolar complex pedicle.

conclusionsIn this study, modifications included subareolar crescentic incisions and cylindrical excisions in the superior medial and lateral pillar regions. This technique produced satisfactory results for all types of breasts in terms of good breast shape, natural image at the upper pole of the breast, good projection, and reduced bottoming-out deformity. This simple modified technique maintained the size of the breasts and avoided augmentation by breast implants. LEVEL OF EVIDENCE V: 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 .