ORIGINAL PAPER Combined superior crescentic total glandular augmentation mastopexy: report of 37 cases Erdem Güven & Ali Sakinsel & Karaca Başaran & Memet Yazar & Mehmet Bozkurt & Samet Vasfi Kuvat Received: 8 December 2010 / Accepted: 23 March 2011 / Published online: 4 May 2011 # Springer-Verlag 2011 AbstractMethodsof periareolar, donut,or crescentic patterns for augmentation mastopexy in mild to moderate ptosis cases are minimally invasive (short scar) options. In this article, we report a modified version of the classical crescentic technique of augmentation mastopexy, namely, “superior crescentic total glandular augmentation mastopexy”. Thirty-seven patients with (a) breasts having mild to moderate ptosis (Regnault grades I–II), (b) breasts requiring less than 3 cm of nipple–areola elevation, and (c) mild skin elasticity were included in the study. During surgery, the mean size of 290 cc of silicon gel-filled implants were placed. The mean follow-up was 39 months ranging from 6 and 58 months. None of the patients had disastrous complications such as skin or nipple–areolanecrosis.Poor scarhealingand areolar asymmetry were the main problems encountered during follow-up.Ptosis recurrence (n=1), and capsular contracture (n=1)were the main reasons for revision surgery (5.4%). Five patients were re-operated on due to complications and implantchangerequirements (13.5% , totalrevisions). Mean suprasternal notch–nipple distance was recorded as 20.8 cm (19.3–22.4 cm) postoperatively. After an average time of 39 months,this distancewas found to be 21.2 cm (20.1–23.2 cm) (the casewith the recurrent ptosis was excluded). Superiorcrescentic total glandular augmentation mastopexy has yielded satisfactory results in patients with mild to moderate breast ptosis;therefore, it seems to be a valuable option in terms of minimally invasive augmentation mastopexy techniques. Keywords Augmentation mastopexy . Superior crescentic . Mild moderate breast ptosis Introduction Whereas mild breast ptosis can be corrected with augmen alone,moderate to severeptosisrequiresaugmentation mastopexy [ 1–4]. Combinedtechniques of single-stage mastopexy and augmentation surgery were first performe Gonzales-Ulloa [5] and Regnault [6]. In spite of the easiness of augmentation andmastopexyoperationsperformed separately, combination at the same time brings certain problems [7–10].In one study reported by Spear et al., 8.8% of augmentation mastopexy patients experienced complications and 14% of them required revisions [7]. In another series, the authors observed 17% complications a 8% revision [8]. Although Spear reported the probability o severe complications such as flap or nipple necrosis, none have been reported in those large series. In a study presented by Stevens et al., saline implant deflation, poor scarring, areola asymmetry, recurrent ptos and capsular contracture were the main complications [ 11 13].Major revision was needed in patients who demanded a different implantsize postoperatively. A 14.6% revision rate for combined mastopexy and augmentation techniqu E. Güven : K. Başaran : M. Yazar : S. V. Kuvat (*) Department of Plastic and Reconstructive Surgery, İstanbul Medical Faculty, Seyitömer Mah. Emrullah Efendi Sok. No: 60/6 Fındıkzade 34098 Fatih, İstanbul, Turkey e-mail: sametkuvat@yahoo.com A. Sakinsel Department of Plastic and Reconstructive Surgery, Bakırköy Leonart Aesthetic Centre, İstanbul, Turkey M. Bozkurt : S. V. Kuvat Department of Plastic and Reconstructive Surgery, Dicle Medical Faculty, Diyarbakır, Turkey Eur J Plast Surg (2012) 35:43–48 DOI 10.1007/s00238-011-0577-y