Periareolar subpectoral augmentation mammaplasty.

A modification of an established technique to augment the breast is described. Thirty patients underwent subpectoral augmentation though a periareolar incision with a follow-up period of 10 to 16 months. The purpose was to combine the benefit of subpectoral placement (to minimize capsular contracture) with an inconspicuous scar, which usually results from the periareolar approach. Under general anesthesia a periareolar incision was used. Dissection proceeded straight down to the pectoralis muscle, which was split between its fibers to enter the areolar subpectoral plane. The origin of the muscle from the ribs and part of the sternum was detached and the pocket was subcutaneously extended lateral to the muscle. Thus a larger than otherwise expected implant could be inserted without the problem of displacement by the muscle, Postoperative tonometry was done to quantitate the degree of breast softness. Initial results suggested that (1) the incidence of capsular contracture can be reduced by virtue of using th subpectoral plane; (2) breast tonometry measurements of brest softness or firmness correlate well with the clinical impression; (3) the periareolar scar is superior to the inframammary scar; and (4) the periareolar approach allows easy access to the subpectoral plane and allows for better visualization of the muscular detachment.