Mammoplasty Using a Periareolar Approach

Abstract

The development of mammoplasty was initially marked by techniques that sought to achieve a good shape and projection of the breasts and resulted in large scars, as described by several authors. Later, there was a demand for techniques of breast reduction that resulted in progressively smaller scars, such as the L technique, vertical, and finally periareolar scars. Initially, the periareolar technique failed because of skin necrosis secondary to large subcutaneous detachments. Knowledge of the importance of preserving the subdermal vascular plexus and the standardization of this dissection ensured adequate skin vascularization and eliminated severe necrosis. Complications such as increased areola diameter and early ptosis were corrected with the application of a round block periareolar suture and adjustments in parenchymal resections respectively. In the technique presented here, the upper pole V resection associated with fixation of the breast muscle plane, ensures good projection of the breast and stable results in the medium and long term. The final scars around the areola have achieved a good appearance, which encouraged us to employ the technique.