Periareolar mammaplasty with mixed mesh support: The double skin technique

Abstract

My 8-year experience of operating on 287 patients via a personal mammaplasty technique with a periareolar approach is presented. The technique is based on the principle that the skin alone does not prevent early ptosis. It proposes the repositioning of all breast connective structures, treating the glandular tissue separately from the cutaneous covering. This cutaneous covering is double-layered, using a circular flap of deepithelialized dermis over the central pedicle around the areolar region as the inner layer. For this purpose, the following structures have been used which, once repositioned and brought together, will act as a support network: (1) the anterior pectoral fascia; (2) Cooper's intramammary ligaments; (3) a periareolar dermal flap, used as a skin inner lining; (4) mixed mesh (polyglactine plus polyester) positioned as a sandwich between both layers of skin; and (5) the external cutaneous covering that completes the double-layered skin assembly.