Periareolar Mastopexy
Mastopexy is a commonly performed aesthetic breast procedure. The specific type of mastopexy is dependent upon the degree of breast ptosis and may include a periareolar, circumvertical, and inverted T method. The periareolar or circumvertical mastopexy is
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Maurice Y. Nahabedian
Indications
Intraoperative Details
1. To elevate the position of the nipple areolar complex on the breast 2. Grade 1 breast ptosis
1 . Eccentric periareolar incisions. 2. De-epithelize crescent of skin. 3. Score dermis. 4. Dermal and epidermal closure.
Essential Steps
Postoperative Care
1. For mild breast ptosis without glandular ptosis 2. Dermal scoring with mild undermining
1 . Keep incisions covered and dry × 72 h. 2. Postoperative antibiotics × 2–5 days.
Preoperative Markings
Possible Complications
1 . Delineate sternal midline. 2. Delineate inframammary fold. 3. Mark ideal position of the nipple areolar complex. 4. Eccentric or circular periareolar pattern.
1. Delayed healing 2. Diminished nipple areolar sensation 3. Complex scar 4. Asymmetry
Operative Dictation
M.Y. Nahabedian, M.D. (*) Department of Plastic Surgery, Georgetown University, Washington, DC 20007, USA e-mail: [email protected]
Diagnosis: 1. History of breast cancer 2. Contralateral breast ptosis 3. Breast asymmetry Procedure: Unilateral periareolar mastopexy
© Springer International Publishing Switzerland 2017 T.A. Tran et al. (eds.), Operative Dictations in Plastic and Reconstructive Surgery, DOI 10.1007/978-3-319-40631-2_31
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M.Y. Nahabedian
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Indications This is a middle-age female with breasts that demonstrate grade 1 ptosis. The plan is to perform an eccentric periareolar mastopexy for symmetry.
Description of the Procedure The patient is marked in the preoperative holding area. The sternal midline and the inframammary fold were delineated. The ideal nipple position was marked and correlated to the level of the inframammary fold. The patient was taken to the operating room and placed in the supine position. Pneumatic compression garments were applied. Preoperative intraoperative antibiotics were intravenously administered. The patient was prepped and draped in the usual sterile fashion. A time-out was performed. The existing diameter of the nipple areolar complex was desired and delineated. An eccentric, superiorly oriented pattern was drawn around the nipple areolar complex. A #15 scalpel was used to incise around the eccentric
pattern and the outlined nipple areolar complex. The upper crescent of skin was de-epithelized. The dermis was scored along the outer pattern and the peripheral skin of the breast was undermined approximately 1–2 cm using electrocautery. The field was irrigated with an antibiotic solution. Hemostasis was ensured using electrocautery. A 3-0 absorbable monofilament suture was used to align and suture the dermis of the nipple areolar complex to the dermis of the surrounding skin. A 4-0 absorbable monofilament suture was used as a subcuticular. This procedure was well tolerated without complications. Dressings were applied. Needle and sponge counts were correct.
Suggested Reading Hidalgo DA, Spector JA. Mastopexy. Plast Reconstr Surg. 2013;132:642e–56. Rohrich RJ, Thornton JF, Jacubietz RG, Jacubietz MG, Gunert JG. The limited scar mastopexy: current
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