Circumareolar Augmentation Mastopexy

The circumareolar (periareolar) mastopexy is an extremely versatile technique that can facilitate multiple types of aesthetic improvements of the breast, including elevation of the nipple areolar complex (NAC), reduction of areola size, improvement of breast symmetry, tightening of the skin envelope, and compression of a herniated areola as in the case of tuberous breasts. The technique also avoids a vertical scar on the breast, which is a significant benefit for many patients concerned about visible scars. The technique has earned a bad reputation for scar spread and distortion of the breast due to overaggressive skin resection or use in cases where a vertical mastopexy is more appropriate. This chapter will discuss how to assess patients based on their anatomy and determine whether a circumareolar mastopexy is an appropriate technique to use. It will also discuss how to design the skin resection pattern and execute the procedure in a way that minimizes risks of scar spread, wound healing issues and other complications.