Application of the Goes double-skin peri-areolar mastopexy with and without implants: A 14-year experience

Peri-areolar mastopexy is commonly used for mild ptosis requiring no more than 3 cm of nipple elevation. The nature of areolar scar and gland remodelling inherent to a circular skin reduction prompts circumspection when correcting more moderate-to-severe cases. The purpose herein is to convey the reproducibility and applicability of the Goes double-skin peri-areolar mastopexy without mesh, for breast ptosis requiring nipple elevation of 4-9 cm, in a series outside the work of the principal innovator. A series of 217 consecutive patients underwent circumareolar eccentric skin excision based on four cardinal landmarks, deepithelialised dermal sleeve and glandular reshaping with and without implants (174 augmentation-mastopexies and 43 mastopexies). Implantation and implant change involved the use of saline implants placed in the subpectoral space. Average nipple elevation was 5.1 cm in the augmentation-mastopexy group and 6.5 cm in the mastopexy group. There were major complications in 4.4% of breasts and occurred only in the mastopexy-augmentation group. There was no nipple loss, serious infection or haematoma. There were minor complications in 13.1% of breasts (11.8% in the mastopexy-augmentation group, and 18.6% in the mastopexy group). A minimal (10%) areolar necrosis occurred on a breast in one patient undergoing augmentation-mastopexy for tubular breasts with micromastia. Revision rate was 4% for the entire series. Based on the principles of circular skin design with fixed skin landmarks, internal breast shaping and special attention when augmentation is done simultaneously, the peri-areolar double-skin mastopexy can be safe, effective and reproducible when applied to cases of increasing complexity. (C) 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.