A Modified Periareolar Auto-augmentation Mastopexy: Using an Inferolaterally Pedicled Tongue-Shaped Parenchymal Flap

The increasing demand for correcting ptosis has made mastopexy one of the most common procedures in plastic surgery. While various techniques have been developed, clinical outcomes often require refinement. In this study, we employed an inferolaterally pedicled, tongue-shaped parenchymal flap to perform auto-augmentation mastopexy via periareolar approach.

Periareolar double-ring incisions were designed, de-epithelialization was performed between the inner and outer circles. Following subcutaneous separation of the breast parenchyma, an inferolaterally based, tongue-shaped parenchymal flap was elevated and rotated to fill posterior space of the breast, raising the nipple-areola complex (NAC). The parenchyma on both sides of the incision was sutured together to reduce the breast base and enhance central breast projection. The breast measurements and BREAST-Q scores were used to assess clinical outcomes and patients' satisfaction. Patients were also asked to rate their nipple sensation.

A total of 34 female patients were retrospectively analyzed after being treated with our modified auto-augmentation mastopexy technique from January 2016 to June 2023. All patients healed without postoperative complications such as poor wound healing, hematoma, infection, or nipple necrosis. Four patients reported decreased nipple sensation postoperatively. Breast measurements revealed improved projection, nipple elevation, and significant reductions in both mammary base width and areola diameter. BREAST-Q scores indicated significant improvements in postoperative breast satisfaction and quality of life.

Our modified periareolar auto-augmentation mastopexy provides a viable solution for patients with mild to severe breast ptosis, excluding cases with insufficient breast volume, seeking breast ptosis correction without synthetic materials or implants. This technique delivers natural, aesthetically pleasing results, significantly enhancing both patient appearance and quality of life.

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