Background Breast ptosis commonly arises from tissue laxity associated with aging, weight fluctuations, pregnancy, or lactation, often accompanied by upper-pole volume depletion. Post-lactational atrophy further exacerbates ptosis, causing physical and psychological distress. Traditional mastopexy techniques typically focus on vertical tightening and may insufficiently address horizontal glandular laxity. This study evaluates a three-dimensional (3D) conceptual approach for simultaneous augmentation-mastopexy via a circumareolar incision, aiming to correct mild-to-moderate breast ptosis and restore optimal breast contour. Methods A retrospective analysis was conducted on 51 female patients (102 breasts; mean age 32.52 ± 4.62 years) with mild-to-moderate breast ptosis who underwent single-stage augmentation-mastopexy using our 3D conceptual technique. The surgical design featured a circumareolar incision, limited glandular tissue excision at the upper pole, and dual-plane implant placement. Perioperative data, including ptosis grade, operative time, implant size, and short-term complications, were meticulously recorded. Patient satisfaction was assessed via a Likert scale (0 = poor, 10 = very satisfied), and mean follow-up was 6.96 ± 2.96 months. Results Preoperatively, 78.43% of breasts had Grade II ptosis, and 21.57% had Grade I ptosis. The mean nipple-to-midclavicular distance decreased significantly from 24.22 ± 1.55 cm to 19.18 ± 0.78 cm, yielding a mean nipple position change of 4.71 ± 1.02 cm. The mean implant volume was 267.63 ± 38.50 mL, and the mean operative time was 143.73 ± 16.43 minutes. Scarring was minimal around the areola, and periareolar wrinkles typically resolved within 3–6 months. The overall complication rate was 5.88%, with no capsular contracture or NAC necrosis reported. Patient satisfaction was high (8.94 ± 0.83), and NAC sensation was preserved in all cases. Conclusions The 3D conceptual augmentation-mastopexy via a circumareolar incision offers a comprehensive solution for mild-to-moderate breast ptosis. By integrating limited glandular resection with vertical and horizontal tightening, this technique restores breast contour, preserves NAC sensitivity, and achieves high patient satisfaction with minimal scarring. Post-lactational breast atrophy and accompanying ptosis can thus be effectively managed using this approach, relieving both physical and psychological burdens. Level of Evidence IV The journal asks authors to assign a level of evidence to each article. For a complete description of Evidence-Based Medicine ratings, see the Table of Contents or the online Instructions for Authors at <a href="http://www.springer.com/00266">www.springer.com/00266</a>.

Three-Dimensional Concept in Simultaneous Periareolar Augmentation-Mastopexy

期刊论文
发表日期：

2025年11月10日

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Shuai Qiang,
Jia-Yang Wang,
Na Wang,
Si-Ming Wei,
Zhao-Xiang Zhang

摘要

Background

Breast ptosis commonly arises from tissue laxity associated with aging, weight fluctuations, pregnancy, or lactation, often accompanied by upper-pole volume depletion. Post-lactational atrophy further exacerbates ptosis, causing physical and psychological distress. Traditional mastopexy techniques typically focus on vertical tightening and may insufficiently address horizontal glandular laxity. This study evaluates a three-dimensional (3D) conceptual approach for simultaneous augmentation-mastopexy via a circumareolar incision, aiming to correct mild-to-moderate breast ptosis and restore optimal breast contour.

Methods

A retrospective analysis was conducted on 51 female patients (102 breasts; mean age 32.52 ± 4.62 years) with mild-to-moderate breast ptosis who underwent single-stage augmentation-mastopexy using our 3D conceptual technique. The surgical design featured a circumareolar incision, limited glandular tissue excision at the upper pole, and dual-plane implant placement. Perioperative data, including ptosis grade, operative time, implant size, and short-term complications, were meticulously recorded. Patient satisfaction was assessed via a Likert scale (0 = poor, 10 = very satisfied), and mean follow-up was 6.96 ± 2.96 months.

Results

Preoperatively, 78.43% of breasts had Grade II ptosis, and 21.57% had Grade I ptosis. The mean nipple-to-midclavicular distance decreased significantly from 24.22 ± 1.55 cm to 19.18 ± 0.78 cm, yielding a mean nipple position change of 4.71 ± 1.02 cm. The mean implant volume was 267.63 ± 38.50 mL, and the mean operative time was 143.73 ± 16.43 minutes. Scarring was minimal around the areola, and periareolar wrinkles typically resolved within 3–6 months. The overall complication rate was 5.88%, with no capsular contracture or NAC necrosis reported. Patient satisfaction was high (8.94 ± 0.83), and NAC sensation was preserved in all cases.

Conclusions

The 3D conceptual augmentation-mastopexy via a circumareolar incision offers a comprehensive solution for mild-to-moderate breast ptosis. By integrating limited glandular resection with vertical and horizontal tightening, this technique restores breast contour, preserves NAC sensitivity, and achieves high patient satisfaction with minimal scarring. Post-lactational breast atrophy and accompanying ptosis can thus be effectively managed using this approach, relieving both physical and psychological burdens.

Level of Evidence IV

The journal asks authors to assign a level of evidence to each article. For a complete description of Evidence-Based Medicine ratings, see the Table of Contents or the online Instructions for Authors at www.springer.com/00266.