Areola-Nipple Perception Threshold to Faradic Electricity: A New Measure of Sensibility of the Breasts

Background  We describe a new method to study the sensibility of the nipple-areola complex of the breast with faradic electricity delivered through an electromyographic device used to monitor peripheral nerve conduction. Methods  The objective results of faradic pulses (2–50 mA per pulse) delivered to the nipple-areola complex of the breast through a Nihon-Kohden II machine (Evoked potential/Electromyographs, Nihon-Kohden Co., Japan) were evaluated in normal volunteers to get a basal measure that was defined by the patient as “a soft electric discharge.” The measures were recorded and their output discharges averaged (at least 5 to each complex). Results  Twenty-eight volunteers with normal breasts, 28 patients with breast hypertrophy before and after breast reduction, and 28 patients before and after breast augmentation were studied. The faradic pulses were perceived from 1.5 to 3.5 mA in the areola and from 3 to 5.5 mA in the nipple in the control group and from 4.5 to 7.0 mA in the areola and from 6.5 to 9.5 mA in the nipple in the breast hypertrophy group with no significant changes before and after surgery. In the breast augmentation group the faradic pulses were very similar to the volunteers that had normal breasts, but 13 months after breast augmentation with silicone gel prosthesis, a difference was found because all the patients had a higher threshold and three cases had lost sensibility of the nipple-areola complex. Conclusion  In normal breasts the areola had a lower threshold for faradic pulses compared to the nipple. Hypertrophic breasts had a higher threshold to the faradic stimulation than normal subjects in the pre- and postoperative period. Hypoplastic breasts before breast augmentation had a perception threshold similar to that of the normal volunteers but after breast augmentation this perception was much higher. This study received the Scientific Exhibit Award at the ASAPS/ASERF Annual Meeting in Vancouver, British Columbia, Canada, 2005.     

Breast volume measurement in 125 Chinese young women

The author carried out measurement of breast volume and the body surface anatomy in 125 unmarried young women. Through the measurement and analysis, the author came to the following conclusions: 1. The characteristics of body build of Chinese young women are: a. The mean height: 159.00 cm-160.00 cm; The mean weight: 50.40 kg-60.00 kg; The standard weight: height minus 110. b. The mean chest circumference difference, 2.0 cm. c. The mean distance from nipple to the supra-sternal notch is 19.05 cm, that of between nipples 20.0 cm, forming a equilateral triangle. d. The average breast volume, 310-330 ml; The standard breast volume, 250-350 ml; if the body weight is over the standard, the breast volume increases by 20 ml every 1.0 kg in body weight. e. The standard breast forward projection: 3.0 cm-4.0 cm. 2. Variables of the breast volume are: a. The breast volume is positively correlated with weight, chest circumference, waist circumference and buttock circumference, but negatively with height. b. The breast volume is closely related to difference between the chest circumference across the nipple and that across the horizontal line just under the armpits. The correlative equation can be approximately represented as V = 250 + 50 x D + 20 x OW (D = difference OW = overweight). c. The nipple position is not dependent on the height, but varies with the breast volume, that is, the nipple position lowers 1.0 cm with every increase of 300 ml in the breast volume. 3. The breast volume calculating table is derived from the radius and forward projection of breasts.(ABSTRACT TRUNCATED AT 250 WORDS)     

Geometric Incision Design for Reduction Nippleplasty

Background

Nipple hypertrophy is a frequently encountered problem in Asian women. It may be congenital or caused by hormones, breast feeding, or gestation. The hypertrophy has been linked primarily to aesthetics. The nipples of Asian women usually are 6?C10?mm in diameter and 5?C8?mm in height, and women with nipples larger than 1.5?cm in diameter or height frequently ask for reduction nippleplasty.

Methods

Women with nipple hypertrophy seeking reductive surgery at the authors?? hospital between 2004 and 2009 were considered for nippleplasty. A new design consisting of three dermal flaps and sparing of the central column was used. This design can reduce the diameter, height, and most importantly, the basal shape of the nipple without compromising neurovascular supply and functions.

Results

During the aforementioned period, 86 nipples of 43 patients were corrected with this method. All the patients were satisfied with the aesthetic results, preserved lactation, and sensory function. No major complications such as necrosis, infection, or numbness of the nipple occurred.

Conclusions

This reduction nippleplasty method can be applied for all types of nipple hypertrophy to create a new nipple of the desired height and diameter without significant complications.     

Breast reduction with use of the free nipple graft technique

In properly selected patients, the results of free nipple graft breast reduction may be equal or superior to a pedicle technique. A free nipple graft is clearly indicated for gigantomastia, but it is also useful in severe macromastia, when a large, bulky pedicle may impede adequate reduction and optimal contour, and in patients with fatty breasts and inverted nipples. Disadvantages include the loss of ability to breast-feed, loss of nipple sensation, and possible hypopigmentation in the nipple-areola. The author discusses patient selection and describes execution of this technique. (Aesthetic Surg J 2001;21:261-271.)     

Nipple-Sparing Mastectomy in 99 Patients With a Mean Follow-up of 5 Years

Background

The safety and practicality of nipple-sparing mastectomy (NSM) are controversial.

Methods

Review of a large breast center’s experience identified 99 women who underwent intended NSM with subareolar biopsy and breast reconstruction for primary breast cancer. Outcome was assessed by biopsy status, postoperative nipple necrosis or removal, cancer recurrence, and cancer-specific death.

Results

NSM was attempted for invasive cancer (64 breasts, 24 with positive lymph nodes), noninvasive cancer (35 breasts), and/or contralateral prophylaxis (50 breasts). Twenty-two nipples (14%) were removed because of positive subareolar biopsy results (frozen or permanent section). Seven patients underwent a pre-NSM surgical delay procedure because of increased risk for nipple necrosis. Reconstruction used transverse rectus abdominis myocutaneous flaps (56 breasts), latissimus flaps with expander (35 breasts), or expander alone (58 breasts). Of 127 retained nipples, 8 (6%) became necrotic and 2 others (2%) were removed at patient request. There was no nipple necrosis when NSM was performed after a surgical delay procedure. At a mean follow-up of 60.2 months, all 3 patients with recurrence had biopsy-proven subareolar disease and had undergone nipple removal at original mastectomy. There were no deaths.

Conclusions

Five-year recurrence rate is low when NSM margins (frozen section and permanent) are negative. Nipple necrosis can be minimized by incisions that maximize perfusion of surrounding skin and by avoiding long flaps. A premastectomy surgical delay procedure improves nipple survival in high-risk patients. NSM can be performed safely with all types of breast reconstruction.     

The Lateral Inframammary Fold Incision for Nipple‐Sparing Mastectomy: Outcomes from Over 50 Immediate Implant‐Based Breast Reconstructions

Nipple‐sparing mastectomy (NSM) as a therapeutic or prophylactic procedure for breast cancer is rapidly gaining popularity as the literature continues to support it safety. The lateral inframammary fold (IMF) approach provides adequate exposure and eliminates visible scars on the anterior surface of the breast, making this incision cosmetically superior to radial or periareolar approaches. We reviewed 55 consecutive NSMs performed through a lateral IMF incision with immediate implant‐based reconstruction, with or without tissue expansion, between June 2008 and June 2011. Prior to incision, breasts were lightly infiltrated with dilute anesthetic solution with epinephrine. Sharp dissection, rather than electrocautery, was used as much as possible to minimize thermal injury to the mastectomy flap. When indicated, acellular dermal matrix was placed as an inferolateral sling. Subsequent fat grafting to correct contour deformities was performed in select patients. Three‐dimensional (3D) photographs assessed changes in volume, antero‐posterior projection, and ptosis. Mean patient age was 46 years, and mean follow‐up time was 12 months. Twelve mastectomies (22%) were therapeutic, and the remaining 43 (78%) were prophylactic. Seven of the nine sentinel lymph node biopsies (including one axillary dissection) (78%) were performed through the lateral IMF incision without the need for a counter‐incision. Acellular dermal matrix was used in 34 (62%) breasts. Average permanent implant volume was 416 cc (range 176–750 cc), and average fat grafting volume was 86 cc (range 10–177 cc). In one patient a positive intraoperative subareolar biopsy necessitated resection of the nipple‐areola complex (NAC), and in two other patients NAC resection was performed at a subsequent procedure based on the final pathology report. Mastectomy flap necrosis, requiring operative debridement, occurred in two breasts (4%), both in the same patient. One of these breasts required a salvage latissimus dorsi myocutaneous flap to complete the reconstruction. Three nipples (6%) required office debridement for partial necrosis and operative reconstruction later. No patient had complete nipple necrosis. No statistically significant differences existed between therapeutic and prophylactic mastectomies for developing partial skin and/or nipple necrosis (p = 0.35). Three episodes (5%) of cellulitis occurred, which responded to antibiotics without the need for explantation. Morphological outcomes using 3D scan measurements showed reconstructed breasts were larger, more projected, and less ptotic than the preoperative breasts (196 versus 248 cc, 80 versus 90 mm, 146 versus 134 mm, p < 0.01 for each parameter). Excellent results can be achieved with immediate implant‐based reconstruction of NSM through a lateral IMF incision. NAC survival is reliable, and complication rates are low. blechmanplasticsurgery.com     

Mammaplasty: The “Super Flap” or the Superior Pedicle Extra Long Flap for Massive Breasts with Marked Ptosis or Gigantomastia

Background  Very large breasts associated with ptosis frequently present a challenge to the plastic surgeon in choosing the ideal procedure to obtain a satisfactory result. A free nipple graft, which for many represents the best option in these conditions, has many disadvantages. Methods  The author’s method of a superior pedicle flap allows for very long flaps, in some cases over 40 cm, and breast ptosis with the nipple at more than 55 cm from the suprasterna notch with preservation of the circulation to the nipple-areola complex. This procedure has been developed and modified from the French oblique method of Dufourmentel and Mouly converted to an inverted T, while the glandular resection is performed in a keel fashion behind the areola to house and give room for these very long flaps without undue compression on them and endangering the blood supply to the areola-nipple complex. Results  The method is described in detail, the early and late results presented, and advantages and disadvantages discussed. It has stood the test of time as it has been used regularly for more than 20 years and has become our standard method. Conclusion  The method presented is especially suitable for very large breasts with ptosis; however, excellent results are also achieved for all other degrees of ptosis, with very little modification in the procedure needed to suit different breast sizes and shapes. Most of the time we obtain a pleasing and attractive breast. This method rarely resulted in complications and never required a blood transfusion.     

锲形纵切与环切相结合的手术方法治疗乳头肥大的临床效果

目的 分析锲形纵切与环切相结合的手术方法治疗乳头肥大的临床效果。方法 选取2020年 2月-2022年3月湖南省职业病防治院收治的40例乳头肥大患者，所有患者均实施锲形纵切与环切相结合 的手术方案，比较术前术后乳头高度、直径及患者满意度，记录不良反应发生情况，观察患者术后 愈合情况。结果 治疗后乳头直径、高度低于治疗前（P＜0.05）；治疗后患者满意度评分高于治疗前 （P＜0.05）；40例患者均未出现不良反应，随访半年后，愈合良好，双侧对称，患者的乳头感觉以及勃起 功能正常。结论 锲形纵切与环切相结合的手术方法治疗乳头肥大的临床效果较好，可有效改善患者乳头 直径和高度，且安全性较高，恢复较快，对提升女性患者乳房的美观度具有积极影响。     

Nipple-areola reconstruction: outcome assessment

The creation of the nipple-areola complex (NAC) is usually the final step in the surgical treatment of breast cancer patients. It has substantial aesthetic and symbolic implications for the patients involved. In this study we reviewed 17 consecutive nipple-areola reconstructions over a 4-year period. Breast reconstruction in these patients was performed using a combination of breast implant only (n=4) and flap reconstructions (latissimus dorsi, TRAM) (n=13). The skate flap technique was used for nipple reconstruction in all of these patients. Patients were assessed objectively and subjectively. Follow-up ranged from 1 to 48 months (mean 20 months). Mean nipple projection at review was 6.75 mm (range 5.2–9 mm) and mean nipple diameter was 12 mm (range 8–14 mm). The majority of the patients were satisfied with the results.An editors comment to this paper can be found at .     

Innervation of the Male Breast: Psychological and Physiological Consequences

Breasts, including the nipple and areola, have two functions: lactation and as an erogenous area. Male breasts are much less studied that those of women. In men, breasts have only an erotic function. Because there is dense and very well organized innervation of the nipple-areola complex in men, nipple erection occurs frequently and via different mechanisms from penile erection. Although it seems to be less important for men than for women and it is poorly studied, the erotic value of breast stimulation is notable. Consequently, there is a need to include this aspect in sexological and andrological studies and to preserve breasts and their innervation or to reconstruct them in cases of surgical intervention.     

下蒂瓣法乳房缩小整形术的效果

目的:探讨下蒂瓣法乳房缩小整形术治疗中重度乳房肥大症的方法及效果。方法:2010年1月至2019年12月,南京医科大学附属妇产医院整形外科对19例女性患者(年龄18~54岁,平均36.2岁)38侧肥大乳房,以Robbins的垂直下蒂瓣术式为基础,结合乳房血供、神经等解剖学进展,进行乳晕设计、下蒂瓣位置等改进。结果:19...     

Optimizing the nipple-areola sparing mastectomy with double concentric periareolar incision and biodimensional expander-implant reconstruction: Aesthetic and technical refinements

Although the biodimensional anatomical expander-implant system (BEIS) is a reliable technique, little information has been available regarding outcome following nipple-areola sparing mastectomy (NSM). To perform the resection of glandular tissue, while improving the surgical access and maintaining the nipple-areola vascularization we have developed a new approach for NSM based on the double concentric periareolar incision (DCPI). The purpose of this study is to analyze the feasibility, surgical planning and its outcome following NSM. 18 patients underwent NSM reconstructions. Mean time of follow-up was 29 months. The technique was indicated in patients with small/moderate volume breasts. Flap complications were evaluated and information on aesthetic results and patient satisfaction were collected. 83.3% had tumors measuring 2 cm or less (T1) and 72.1% were stage 0 and I. All patients presented peripherally tumors located (at least 5 cm from the nipple). Skin complications occurred in 11.1%. One patient (5.5%) presented small skin necrosis and a wound dehiscence was observed in one patient (5.5%). The aesthetic result was good/very good in 94.4 percent and the majority of patients were very satisfied/satisfied. No local recurrences were observed. All complications except one were treated by a conservative approach. DCPI–BEIS is a simple and reliable technique for NSM reconstruction. The success depends on patient selection, coordinated planning with the oncologic surgeon and careful intra-operative and post-operative management.     

一种保留哺乳功能的乳头内陷矫正术研究

目的:探索一种保留育龄期孕前患者哺乳功能的乳头内陷矫正方法。方法:临床纳入乳头内陷程度为Ⅰ型、Ⅱ型的孕前育龄患者各60例,随机分为Ⅰ型手术组、Ⅰ型对照组、Ⅱ型手术组及Ⅱ型对照组各30例。手术组孕前进行手术,并佩戴矫正器6个月,对照组不予手术处理。同时以乳头发育正常的30例孕前育龄者作为正常组。纳入成功妊娠、生产并尝试哺乳患者,统计乳头高度,母乳喂养情况,乳头皲裂及乳腺炎的发生情况。结果:对于Ⅰ型和Ⅱ型患者,手术组术后即刻及孕晚期,其乳头高度相对术前及对照组均有显著性改善(P0.01),母乳喂养4个月成功率显著提高(P0.05),乳头皲裂和乳腺炎的发生率显著降低(P0.05),且除Ⅱ型患者的术后乳头高度外,与正常组比较差异无统计学意义(P0.05)。结论:对于Ⅰ型及Ⅱ型乳头内陷,佩戴乳头内陷矫正器除可增加乳头高度外,可在保留哺乳功能的同时,降低产后乳头皲裂和乳腺炎发生率。     

Nipple reconstruction: the top hat technique

A new surgical technique was evaluated in 23 nipple-areola complex reconstructions in 18 consecutive patients who underwent breast reconstruction techniques. The author used 2 rows of pursestring sutures, one at the base of the neonipple and the other at the periphery of the neoareola. The pursestring sutures act as a supporting platform. The nipple projection was created by suturing in a vertical fashion: 4 horizontal incisions creating 4 supporting pillars. The Montgomery tubercles were simulated by secondary healing of 2- or 3-mm randomly placed stab incisions in the neoareola. The micropigmentation of the nipple-areola complex was performed preferably 6 weeks before the nipple-areola reconstructions. The mean follow-up time was 18 months. The average nipple projection was 6 mm, and the average diameter was 10 mm. Two patients presented with partial loss of nipple projection. Overall, more than 90% of the patients were satisfied with this procedure.     

Increasing Eligibility for Nipple-Sparing Mastectomy

Background

Eligibility for nipple-sparing mastectomy (NSM) varies widely on the basis of patient and tumor factors.

Methods

Review of patients undergoing NSM from June 2007 to December 2012 at our institution was performed. Patient and tumor characteristics, complications, and recurrences were collected. NSM from 2007 to 2010 and 2011 to 2012 were compared to assess trends in eligibility and outcomes over time.

Results

NSM was performed on 645 breasts in 370 patients. Indications were risk reduction in 330 (51.2 %), invasive cancer in 226 (35.0 %), and ductal carcinoma-in situ in 89 (13.8 %) breasts. Fifty-one (13.8 %) patients had positive lymph nodes. Twenty-seven (7.3 %) patients received neoadjuvant chemotherapy. Forty-eight (7.4 %) breasts had prior radiotherapy. Total nipple necrosis occurred in 11 (1.7 %) breasts. Twenty-four (3.7 %) breasts had nipples removed as a result of positive subareolar/nipple margins. At 22 months’ mean follow-up, local recurrence occurred in 4 of 156 (2.6 %) breasts operated on for cancer through 2011. No recurrences involved the nipple. NSM performed in 2011–2012 (n = 475) compared to 2007–2010 (n = 170), were more often for cancer, in patients with higher body mass index, and on larger breasts (p < 0.001). There was no significant difference in total nipple necrosis rates between groups. Nipple loss due to positive subareolar/nipple margins was significantly less in 2011–2012 (p = 0.027).

Conclusions

Eligibility for NSM has expanded to include women with higher body mass index and larger breasts, with no increase in nipple loss due to ischemia. Rates of positive subareolar margins have decreased over time, even though NSM is being performed more frequently for cancer, suggesting improved patient selection.     

Nipple delay prior to nipple-sparing mastectomy: the protective effect on nipple-areola complex ischaemia

BackgroundNipple-sparing mastectomy (NSM) has become increasingly popular over the past decade, offering perceived superior cosmetic outcomes and psychological benefits. The main concern in NSM is that of nipple-areola complex (NAC) ischaemia, occurring in up to 15% of cases. We investigate the utility of nipple delay (ND) in protecting the NAC from ischaemic complications.MethodsA retrospective study of all NSM for a single surgeon from 2010 to 2020 was performed, with those not receiving a prior ND procedure included as a control arm. Variables were recorded, including time to mastectomy from delay, degree of breast ptosis, cup size, mastectomy weight, previous radiotherapy, and presence of ischaemic risk factors. Outcomes recorded were the development of NAC ischaemia, graded from epidermolysis to partial or full-thickness necrosis (FTN).ResultsA total of 62 women for a total of 84 breasts were part of the delay cohort. Ten (12%) breasts in the delay group developed ischaemic complications, with only five breasts developing FTN requiring debridement. Moreover, 33 women for a total of 43 breasts were part of the non-delay cohort. A total of 14 (33%) breasts in the non-delay cohort developed ischaemic complications, with six breasts developing FTN requiring debridement. Delay was protective against ischaemic complications with an OR 0.28 (p=0.007). Mastectomy weight of >600 g and >400 g predicted the development of ischaemic complications in the delay and non-delay cohorts, respectively.ConclusionND was shown to protect against the development of ischaemic complications prior to NSM, with the greatest protective effects shown in those with morphologically large breasts.     

Nipple migration in a pig using the technique of serial excision.

Moving a misplaced nipple-areola complex (NAC) without causing additional scarring has proved to be difficult, especially if it is to be moved medially, laterally or inferiorly. This study investigated the possibility of migrating the NAC without leaving additional scarring by using the technique of serial excision. Two adult female pigs were used. Three pairs of pseudo-areolas of similar size were tattooed around a teat in each pig. Crescentic serial excisions of skin were undertaken at 2 weekly intervals on the upper and middle pairs of pseudo-areolas in each pig and the lower pairs were left as controls. The crescentic excision on the upper set of nipples consisted of skin only. The crescentic excision on the middle set of nipples consisted of 75% skin and 25% tattooed pseudo-areola. Results showed that nipple migration by serial excision is possible. However, each set of nipple pseudo-areola complex (NPAC) behaved differently. When skin only was excised, the NPAC's became distorted and enlarged but when skin and areola was excised, the NPAC maintained its dimensions. Taking our findings into account, an approach to moving a misplaced NAC using this technique in the clinical situation is described. Its use to move a misplaced NAC in two women is demonstrated.     

动态增强磁共振成像在评估女性乳房乳头乳晕血供的应用

目的探究动态增强磁共振成像(DCE-MRI)用于评估女性乳房乳头乳晕血供特点的可行性,为乳房整形手术提供乳头乳晕的血供参考。方法从2012年3月至2019年10月华中科技大学同济医学院附属同济医院影像数据库中收集女性乳腺DCE-MRI图像资料,选择未发现肿物的正常乳房的DCE-MRI图像进行研究。在西门子工作站将患者乳腺DCE-MRI图像通过图像减影获取乳房血管图像,分别对轴位、冠状位和矢状位的最大密度投影(MIP)图像进行评估,结合三维MIP图像识别所有供应乳头乳晕的血管。乳头乳晕的血供被划分为内上、内侧、内下、外上、外侧、外下、中央、上方和下方9个象限,对各个象限血管进行统计和分析,并测量血管至乳房皮肤表面投影的最大距离。采用SPSS 19.0软件进行统计分析,通过卡方检验分别比较左侧与右侧乳房的乳头乳晕复合体(NAC)血供象限分布构成比。计算血管到皮肤距离的平均值、标准差及95%置信区间,通过方差分析比较各象限血管至皮肤距离的差异。P<0.05为差异具有统计学意义。结果共收集到245例患者490只女性乳房DCE-MRI图像,其中97例患者97只乳房发现有乳腺肿物,其余393只为正常乳房(97例单侧乳房、148例双侧乳房),将其作为研究对象。患者年龄23~72岁,平均43.7岁。393只乳房(左侧200只、右侧193只)共发现有637条(左侧311条、右侧326条)乳头乳晕供应血管。在637条血管中,内上象限269条(42.2%),外上180条 (28.3%),内侧57条(8.9%),下方37条(5.8%),中央30条(4.7%),内下25条(3.9%),外下25条(3.9%),上方11条(1.7%),外侧3条(0.5%)。卡方检验表明左侧乳房和右侧乳房在NAC血供象限分布构成比差异无统计学意义(χ2 =6.4,P=0.602)。除中央象限血管以外,所有血管到皮肤表面投影最大距离的平均值为0.91 cm, 95%置信区间为0.86~0.96 cm。方差分析表明各象限供血血管到皮肤投影的最大距离,差异有统计学意义(F=11.4,P<0.001)。结论 DCE-MRI可以清晰地显示乳头乳晕的血供来源。乳头乳晕血供主要来源于内上象限和外上象限的血管,血管在皮下约1 cm深度走行。     

Transposition of the Malpositioned Nipple-Areola Complex in Breast Reconstruction with Implants

Background  

The goal of breast reconstruction after breast cancer is to obtain symmetrical breasts, including the nipple-areola complex. However, in some cases the nipple-areola complex may not be symmetrical even though a symmetrical breast shape has been created. In such cases the nipple-areola complex has been transpositioned, leaving a scar to close the wound or skin graft in the original position.     

Combined superior crescentic total glandular augmentation mastopexy: report of 37 cases

Methods of periareolar, donut, or crescentic patterns for augmentation mastopexy in mild to moderate ptosis cases are minimally invasive (short scar) options. In this article, we report a modified version of the classical crescentic technique of augmentation mastopexy, namely, “superior crescentic total glandular augmentation mastopexy”. Thirty-seven patients with (a) breasts having mild to moderate ptosis (Regnault grades I–II), (b) breasts requiring less than 3 cm of nipple–areola elevation, and (c) mild skin elasticity were included in the study. During surgery, the mean size of 290 cc of silicon gel-filled implants were placed. The mean follow-up was 39 months ranging from 6 and 58 months. None of the patients had disastrous complications such as skin or nipple–areola necrosis. Poor scar healing and areolar asymmetry were the main problems encountered during follow-up. Ptosis recurrence (n = 1), and capsular contracture (n = 1) were the main reasons for revision surgery (5.4%). Five patients were re-operated on due to complications and implant change requirements (13.5% , total revisions). Mean suprasternal notch–nipple distance was recorded as 20.8 cm (19.3–22.4 cm) postoperatively. After an average time of 39 months, this distance was found to be 21.2 cm (20.1–23.2 cm) (the case with the recurrent ptosis was excluded). Superior crescentic total glandular augmentation mastopexy has yielded satisfactory results in patients with mild to moderate breast ptosis; therefore, it seems to be a valuable option in terms of minimally invasive augmentation mastopexy techniques.