Application of Periareolar Approach to Diverse Mammoplasty

ABSTRACT

Augmentation mammoplasty can be performed through various ways such as transaxillary, inframammary, periareolar and transumbilical approaches according to the patient's breast contour, body shape, and patient's and physician's preference. Each approach has unique pros and cons. From March, 2000 to October, 2002, we have applied periareolar approaches for augmentation mammoplasties in 69 patients, 134 breasts. Periareolar approach has several advantages. It is easy to access to the subpectoral space technically because of shorter distance and direct visualization. It requires smaller incision and leaves inconspicuous scar. Using endoscope, precise dissection of subpectoral space and hemostasis during operation could be achieved. We have kept fill-tube attached to the saline implant even after the surgery in selective cases. On the following day after the surgery, patients could check her breast contour, size, and symmetry by themselves in front of the mirror. Additional adjustment of implant volume was possible in the range of 10 to 15 per cent and it would decrease patient's complaint about the final result. We have introduced endoscope in periareolar augmentation mammoplasty in some cases. It allows us direct visualization of the subpectoral space and the origin of the pectoralis major muscle, and more accurate manipulation and hemostasis were possible. We have applied periareolar approach to various situations such as primary procedures in hypoplastic breasts, asymmetric breasts and secondary procedures in capsular contracture, rupture of mammary implant and combined operation with breast cancer or inverted nipple. Periareolar approach can be applied for diverse cases of mammoplasty, whether it is primary or secondary procedure, successfully because of its easiness, convenience, safety, economical efficacy and positive effect for doctor-patient relationship.