By Tolbert S. Wilkinson M.D., F.A.C.S., Adrien E. Aiache M.D., Luiz S. Toledo M.D. (auth.)

Circumareolar thoughts for Breast Surgery provides the technical options that experience mostly eradicated the issues of the circumareolar strategy - restricting the incision to the areolar epidermis junction, hence averting scars - as utilized to mastopexy within the huge and small breast, aid of the bigger breast, inner breast fix of the augmented breast, for implant removing or alternative, in addition to the function of liposuction. additionally incorporated are the finer issues of strategy, suturing, pre-surgical marking, and post-surgical dressing. With 350 illustrations, this e-book is a must have resource for the plastic surgeon.

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Because earlier publications showed flattened and "pancake" -appearing breasts, with areolae set at a lower position, we discuss here the elevation of the areola by wedge excision, as proposed by Luiz Toledo. 1. Complete preparation of the deepithelial- midline marking. Closure of this triangle sets the nipple at a higher position. One can then ized bed in circumareolar breast surgery. 2. Placement of the first advancement suture, in the deep dermis of the breast skin, preparatory to raising the areola.

Most authors point out that the main advantage of this approach is the existence of only one periareolar scar. 2). 1. " Top: The infraareolar skin is dissected from the gland toward the retromammary space. Bottom: Nonabsorbable sutures are used to elevate the gland and achieve projection of the breast cone. 2. (A) Preoperative and (B) postoperative result with Hinderer's doughnut technique in a ptotic breast. There is widening and flattening of the areola and widening of the periareolar scar. 7 He contraindicates it for moderate and large hypertrophies.

The mastopexy is performed according to Arie's technique (1957t (without the vertical skin resection), infolding the gland and securing it to the pectoral muscle and to the rib periosteum. The indications are to correct ptosis and small to medium hypertrophy. At the time of publication (1975) more than 90% of their patients were young active women under 40 years of age, the ideal candidates for this technique. Bartels, Strickland, and Douglas (Orlando, FL) described in 197610 a mastopexy technique, with or without augmentation, for mild to moderate ptosis that is based on the circumferential excision of skin around the areola.

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