Application of the Goes double-skin peri-areolar mastopexy with and without implants: A 14-year experience.
J Plast Reconstr Aesthet Surg 2009;
64:164-73. [PMID:
20045387 DOI:
10.1016/j.bjps.2009.11.033]
[Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Revised: 09/13/2009] [Accepted: 11/25/2009] [Indexed: 12/16/2022]
Abstract
Peri-areolar mastopexy is commonly used for mild ptosis requiring no more than 3cm of nipple elevation. The nature of areolar scar and gland remodelling inherent to a circular skin reduction prompts circumspection when correcting more moderate-to-severe cases. The purpose herein is to convey the reproducibility and applicability of the Goes double-skin peri-areolar mastopexy without mesh, for breast ptosis requiring nipple elevation of 4-9cm, in a series outside the work of the principal innovator. A series of 217 consecutive patients underwent circumareolar eccentric skin excision based on four cardinal landmarks, deepithelialised dermal sleeve and glandular reshaping with and without implants (174 augmentation-mastopexies and 43 mastopexies). Implantation and implant change involved the use of saline implants placed in the subpectoral space. Average nipple elevation was 5.1cm in the augmentation-mastopexy group and 6.5cm in the mastopexy group. There were major complications in 4.4% of breasts and occurred only in the mastopexy-augmentation group. There was no nipple loss, serious infection or haematoma. There were minor complications in 13.1% of breasts (11.8% in the mastopexy-augmentation group, and 18.6% in the mastopexy group). A minimal (10%) areolar necrosis occurred on a breast in one patient undergoing augmentation-mastopexy for tubular breasts with micromastia. Revision rate was 4% for the entire series. Based on the principles of circular skin design with fixed skin landmarks, internal breast shaping and special attention when augmentation is done simultaneously, the peri-areolar double-skin mastopexy can be safe, effective and reproducible when applied to cases of increasing complexity.
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