Use of nipple-areolar complex to inframammary crease measurements to reduce bottoming out following augmentation mastopexy

Abstract

Augmentation mastopexy is a commonly performed procedure in which breast volume is achieved using an implant, while ptosis correction is done by mobilizing the nipple-areolar complex. Marking for the new nipple-areolar complex is commonly performed considering the degree of ptosis and using the inframammary crease as a reference or measurements taken from suprasternal notch. Commonly used markings are the periareolar, vertical scar or Wise pattern, depending on the degree of ptosis. Implants can be placed in subglandular, partial submuscular or subfascial pocket, and flaps can be superiorly, medially or laterally based. Regardless of the markings used, bottoming out is a common complication following mastopexy with augmentation. An algorithm is presented using preoperative nipple-areolar complex to inframammary crease measurements to reduce bottoming out in such procedures.