The 3-Dimensional "Croissant Mastopexy": Indications and Outcomes

Abstract

Crescent mastopexy is an operation that is often maligned and infrequently used. However, it can be a useful adjunct both in primary augmentation mammaplasty and in secondary breast revision cases. The key to achieving good results with this procedure lies in conceptualizing the operation in 3 dimensions rather than 2. Most publications about the surgical technique describe deepithelialization (or at most full-thickness skin resection) of a crescent-shaped area superior to the areola and a single-layer closure of the defect. Improved outcomes are achieved if a full-thickness composite segment of tissue-skin, subcutaneous fat, and a wedge of breast parenchyma-is resected and the resulting defect closed in multiple layers. A more fitting descriptive term for this procedure, one that conveys the 3-dimensional nature of the tissue resection, is "croissant mastopexy." Croissant mastopexy has been used by the author in primary augmentation in women with mild to moderate ptosis, in patients with asymmetrical nipple position and in patients with tuberous breast deformity. The procedure is also applicable in secondary cases, but precautions must be taken to ensure that blood supply to the nipple is not compromised. When properly executed, croissant mastopexy yields good results without undue stretching of the superior half of the areola and with acceptable scars.