Sub-Areolar Vs Circumareolar Vs SemiAreolar Mastopexy
- Asked by tjra23 in Springfield, IL, USA
- 4 years ago
I am considering a Breast Lift and I am researching my options and I'm not sure if understand the difference or the benefits/downsides of these different procedures. Are there sugury videos available for me to veiw these procedures?
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This is a tough question without seeing you. If you're young with good breast tissue than a circumareolar mastopexy will probably be fine. If you're young and have had several children than you may need this plus implants. If you have significant skin that needs resection then you'll need the periareolar plus a vertical and possibly horizontal incisions.
Do you see where I'm going? It's a complex question with many answers depending on your exam. So go see several surgeons then ask the question.
Sub-Areolar, Semi-areolar, and Circum-areolar Mastopexy
I understand your confusion and it occurs because these terms are often used improperly.
I have tried to clarify these terms for you:
Sub-Areolar = Dermal Mastopexy
This incision goes all the way around the border of the areola and is essentially a modified circumareolar mastopexy popularized by Dr. Becker. I have tried this with moderate success.
Circum-Areolar=Donut = Benelli=Round Block Masotpexy
This incision goes all the way around the areola. Its benefits are the limited scar. The disadvantage are the inability to predict or prevent the pursestring appearance. It tends to flatten the breast and is best performed with an implant. Various techniques have beed described without an implant and have met with mixed success. Attempts at reducing spreading of the scar necessitate the use of a permanent suture which can have problems with infection, palpability, visibility or nipple puffiness. Many modifications have been described. It cannot be used for advanced ptosis (sagging) which is still better managed with a vertical scar ("lollipop or tennis racket")
Semi-Areolar = Peri-Areolar = Crescent Mastopexy
Good for very minor degrees of sagging. It's benefits are its limited scar. The disadvantage is that it will occasionally stretch or enlarge the areola. I have used it primarily as a method to correct uneven nipple height from one side to the other. I rarely use it for a lift on both sides.
I have prepared a video which amy help to explain the confusion. It is based on a lecture I have given in the past. It has been converted from powerpoint, you may want to enlarge the video to see the pictures more clearly.
I hope this helps.
Subareolar vs. Circumareolar Mastopexy
There are technical differences in procedures done with an incision around the areola only.
The technical variations are relatively minor, and just that: technical. Each uses an incision around the areola. The placement of the sutures and the manner that the tissue is tucked varies slightly.
These techniques are suitable for minor changes in nipple position, but often result in flattening of the breast (less projection), and can result in stretching of the scar and of the areola.
It is unfair for you to try to sort this out on your own.
In fact, these are matters over which the experts disagree!
Your best solution is to get a couple of consultations with plastic surgeons, have a thorough discussion about your desires, concerns, and ask about trade-offs.
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What type of Mastopexy is best for me?
Dr. Placik explains the differences beautifully. Each procedure is useful, depending on the distance the nipple needs to be elevated. In some cases, a vertical scar is added when the distance is greater than that which is easily accomodated by a peri-areoar or crescent skin excision. Many patients do not want a vertical scar. However, if the nipple has to be elevated more than about 1.5cm, and if no vertical incision is used, the peri-areolar scar can end up looking like a "sunburst".
This is permanent. The addition of a vertical scar will help prevent this. In addition as Dr. Placik explained, peri-areolar techniques can flatten the breast. Your surgeon should discuss the pros and cons of each method with you and you can decide together what is the best thing for you, given your particular anatomy. There is not one right method that can used in every case. There IS an ideal choice for you, given your needs. Hope this helps.
These are minor lifts and require an implant
What you are describing are minor forms of breast lifting and each needs an implant to drape the extra skin laxity since this extra skin is not excised as it is in a full lift. Make sure you go to an excellent plastic surgeon who can help you sort out what is best for your anatomy and desires.
Web reference: http://www.randcosmeticsurgery.com
Seek the Advice of a Board Certified Plastic Surgeon
I think it would be very difficult for anyone to make an informed decision about which type of breast lift to have without the advice of a Board Certified Plastic Surgeon. I would recommend one or more consults by well-trained surgeons in your area who will give you their best advice and recommendations after a thorough discussion and evaluation. This will be, in my opinion, the best way for you to make an informed decision.
The terms u you mention are not all ones in common use, so I suspect they all mean the same thing, which is a periareolar mastopexy, also called a Benelli or donut mastopexy.
Approaches to mastopexy
There are a number of different techniques available for mastopexy, and each has advantages and limitations. An in depth consultation with a plastic surgeon should provide you with the best options for you.
Breast lift surgery with areaolar incisions
Today there are many techniques available for a breast lift surgery using areolar incisions. If you need just a very small lift and do not need to change the shape or size of the areola, you may be a good candidate for a crescent lift. This will limit the amount of scarring around your areola. Keep in mind that this works well only for patients that require just a small lift of tissue. The majority of patients require a larger lift and so need an incision that goes all the way around the nipple. The only time we place an incision at the bottom edge of the nipple is for a breast augmentation not a breast lift.
There are many variations of mastopexy procedures from simple areola lifts especially with implants to variations of vertical reductions using "lollipop" incisions to more involved procedures using an "anchor" or an inverted "T" incision.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.