Periareolar breast reduction.

A personal approach to periareolar breast reduction is presented. The circular demarcation of periareolar skin must be limited to twice the demarcated areolar diameter (2 x 4 = 8 cm). A cylindrical resection of volume is removed, as in Strömbeck's technique, from below the areola to the aponeurosis of the pectoral muscle. Through this space, two to four "keel-like" parenchymal pieces are removed to reduce the breast at the cardinal points. The breast cone is assembled by suturing the raw areas from bottom to top, hyperprojecting it. A "round-block" suture around the areola is made, and the procedure is concluded with skin suture. Indications, limitations, and possibilities for use of the technique are analyzed, and the equation is summarized as follows: residual ptosis versus long scars inside the limits and indications of more or less 300 g of removed volume and small or medium breast ptosis. Only after the first 10 cases was the limit of the technique determined. Therefore, these results were not homogeneous. The results were satisfactory and regular for 68 of the 78 patients subjected to surgery and follow-up evaluation.