Macroareolar Changes following Periareolar Mastopexy: A Postoperative Assessment

Breast-conserving therapy (BCT) combined with periareolar mastopexy aims to optimize oncological safety and aesthetic outcomes. One known complication is postoperative enlargement of the nipple-areola complex (NAC), which may affect patient satisfaction. This study investigates the frequency and extent of NAC changes following BCT and radiotherapy, using both conventional and three-dimensional imaging for objective measurement.

This retrospective single-center study included 50 women who underwent BCT with periareolar mastopexy and adjuvant radiotherapy between 2019 and 2023. Standardized postoperative assessments were performed ≥6 months after surgery and ≥4 months after radiotherapy. NAC diameters were measured using 3D surface imaging and conventional 2D photographs. Patient-reported satisfaction was assessed using the Breast-Q™ BCT module.

A statistically significant enlargement of the NAC was observed on the operated side. Horizontal diameter increased by 4.4 mm (p < 0.001) and vertical diameter by 3.5 mm (p = 0.006) compared to the contralateral breast. Similar trends were confirmed in 2D images. Postoperative Breast-Q™ scores showed high satisfaction with the nipple (mean: 73 ± 23) and generally favorable ratings in psychosocial and physical well-being.

NAC enlargement is a measurable postoperative change following periareolar mastopexy in the context of BCT and radiotherapy. These findings highlight the relevance of realistic preoperative counseling and planning. While 3D imaging was used exclusively postoperatively, it offers a reproducible tool for outcome evaluation. Future studies should aim to include preoperative baseline data and prospective quality-of-life assessments.