Intra-Areolar Pexy: The "Compass Rose" Suture Technique for Small and Moderate Areola Herniation

Abstract

Background: Common methods for addressing minor tuberous breast (type 0; normal mammary base breast with isolated areolar herniation) do not solve the underlying pathology and may leave an unsightly scar. Objectives: To assess the efficacy and safety of a simple, scarless method based on a novel "compass rose" technique, which addresses the etiology of minor tuberous breast and other cases desiring small areolar diameter reductions. Methods: The technique uses 3 layers of suturing, 1 in a compass pattern and 2 in round block. Retrospective data are provided for 77 consecutive women (141 breasts) undergoing cosmetic breast augmentation surgery and requiring unilateral or bilateral type 0 tuberous breast correction (n = 22) or areolar width reduction ≤ 15 mm (n = 55). Results: Baseline mean age and body mass index were 29.7 ± 6.0 years and 19.4 ± 1.5 kg/m2, respectively. Patients were followed up for a mean of 27.2 ± 19.5 months. In tuberous breast, mean Northwood Index decreased from 0.55 ± 0.06 at baseline to 0.36 ± 0.02 at ≥ 6 months post surgery, indicating minimal residual deformity. In areolar width reductions without tuberosity, mean width decreases of 11.3 ± 1.8 mm (20.0%) were achieved. Patient satisfaction was high with regard to lack of scarring, stability of the result, and overall breast attractiveness. Eight complications were recorded (n = 2 superficial hematoma; n = 3 hypersensibility; n = 2 knot palpability; n = 1 recurrence); all were resolved. Conclusions: The method is effective and safe, and may be applicable across patients with type 0 tuberous breast or desiring small areolar diameter reductions.