Periareolar mastopexy is one form of breast lift that may be useful for very small amounts of ptosis. It is, however, not useful to do a crescent or periareolar breast lift on patients who have severe grade 2 or grade 3 ptosis. Patients have the nipple areolar complex at the inframammary fold may be candidates to simply remove skin above the nipple areolar complex from the 10 o'clock to 2 o'clock position in a periareolar crescent fashion, de-epithelialized the skin and reapproximate it superiorly. Trying to reapproximate larger elevations of the nipple areolar complex can lead to widespread scarring, dehiscence of the incision with increased risks or infections. Patients who have grade 2 ptosis, nipple greater than 1 to 2 cm below the fold or grade 3 ptosis, greater than 3 cm below the fold are not usually candidates for a periareolar lift.
Patients often present to my office requiring both implant to regain volume and fullness as well some form of mastopexy in order to tighten the increasing skin laxity. We also have patients with asymmetry that may present with one breast hypoplastic and tubular as seen in congenital breast asymmetry and the other breast with a grade 1 ptosis which does well a periareolar mastopexy.
We also see significant numbers of breast revisions on patients who have undergone augmentation mammoplasty procedures with large saline implants and small periareolar lifts and now have very large breasts and skin laxity that was not corrected by the improper and inadequate breast lift. Once again, periareolar mastopexies or crescent lifts are useful, but are limited only to patients