Novel Internal Vertical Mastopexy Technique Utilizing a Periareolar Incision

Goals/Purpose: Mastopexy with or without augmentation is a common procedure for patients with breast ptosis. Some patients are scar averse and this can limit the mastopexy portion of the procedure. There are few options for patients not wanting standard vertical or wise pattern mastopexy scars that provide adequate and durable results. Most of the current proposed internal mastopexy options discuss suturing breast parenchyma to the pectoralis muscle fascia and rely on those sutures to provide the lifting effect. Our novel technique uses internal inferior breast pillars to provide the majority of the mastopexy effect. Performing an internal vertical lift utilizing a periareolar incision minimizes scarring for patients while also providing more robust mastopexy results than a crescent or circumareolar mastopexy would allow.

Methods/Technique: A retrospective chart review was performed for a series of patients who all underwent internal vertical mastopexy utilizing only a periareolar incision with or without concurrent breast augmentation by a single board certified plastic surgeon over a twelve year period.

Results/Complications: A total of 34 scar averse patients underwent breast augmentation with the novel internal mastopexy approach from 2012-2024. All patients reported satisfaction post operatively with regards to scarring, NAC position, upper pole fullness and degree of lift achieved. Zero reports of complications, and zero conversion to standard vertical or wise pattern mastopexy. Two patients had capsular contracture, one of which resolved with ASPEN. One patient underwent revision as she wished to downsize her implants, and another underwent an implant exchange and scar revision.

Conclusion: Internal suture vertical mastopexy with or without breast augmentation has proven to be a good option for patients that are scar averse and also do not require major excess skin excision or lifting of a significant distance.