Periareolar Mastopexy: A Historical Appraisal of Technique and Further Technical Refinements Toward Reliable, Lasting, and Reproducible Results

Since its first description in 1976, periareolar mastopexy has attained a negative perception due to perceived high rates of unsatisfactory outcomes. The 2 main reported problems are (1) periareolar scar widening and (2) poor breast shaping. It is the author’s experience that with appropriate refinements in surgical technique based on sound anatomical and surgical underpinnings, good breast shaping and areolar aesthetics can be reliably achieved. This article describes innovations in the technique to improve outcomes, followed by a description of our own technique and refinements over the senior author’s 40-year journey. A literature review of technical refinements in periareolar mastopexy surgical technique was undertaken. Suggested refinements from various authors were then placed in the context of the senior author’s own clinical experience and evolution of technique over 40 years. Representative case studies from the author’s personal series are then presented to illustrate technical pearls and results. Four illustrative cases are discussed, along with a comprehensive description of the senior author’s technique and underlying principles. Early techniques of periareolar mastopexy were plagued by poor breast shaping and areolar distortion. Progressive refinements in technique over the last 50 years have steadily improved surgical outcomes. By combining various published refinements into a single operation, it is now possible to reliably achieve good aesthetic outcomes and avoid previous problems, as shown by the author’s own case series.