Summary: At present, there is no uniform and quantitative indication standard for periareolar augmentation mastopexy. The authors proposed an indication algorithm and a matched approach to delineate the outer circle, to optimize the result of this operation. Five parameters, including both implant and breast characteristics, were incorporated to form an indication algorithm based on three-dimensional measurement. The indication follows the principle that the circumference of the outer circle should be no more than two times the inner circle. To delineate the outer circle, a "crown" was made on the breast. The above approaches were used on patients who came for periareolar augmentation mastopexy from October of 2015 to January of 2019. Data analyzed included BREAST-Q score, areola diameter, the distance of the sternal notch to the nipple preoperatively and 1 year postoperatively, the distance of nipple elevation 1 year postoperatively, and complication and revision rates. A total of 28 breasts (14 patients) were included in this study. BREAST-Q scores 1-year postoperatively showed significant increases in Satisfaction with Breasts, Psychosocial Well-Being, and Sexual Well-Being ( p = 0.000). The mean areolar diameter preoperatively and postoperatively was 6.7 ± 1.2 cm and 4.6 ± 0.4 cm, respectively ( p = 0.000), and the mean sternal notch-to-nipple distance preoperatively and postoperatively was 22.2 ± 1.9 cm and 18.6 ± 1.0 cm, respectively ( p = 0.000), with an average nipple elevation of 3.2 ± 1.1 cm. The overall complication rate was 7.1 percent ( n = 2); both cases were areolar spreading. The overall revision rate was 0 percent. This preliminary study demonstrated the safety and efficacy of the indication and breast crown approach in reducing complication and revision rates.
Clinical question/level of evidence: Therapeutic, IV.
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