Circumvertical reduction mastoplasty: new considerations.

The circumvertical technique is a mixture of the periareolar and the vertical techniques in which the skin resection is performed around the areola and is continued in an inverted cone that starts at the infraareolar area and ends 2-4 cm above the submammary crease. Some advantages of this technique are: The glands are removed from the inferior glandular quadrant and from the inferior borders of the lateral and medial quadrants. The areola is moved upward and attached to the gland, preserving the nursing function. There is a harmonious distribution of the pleats around the areola and at the vertical wound. The vertical suture never crosses the submammary crease. The postoperative result is acceptable. Local anesthesia with vasoconstrictor is used minimizing bleeding. Bupivacaine is also included, prolonging the anesthetic effect hours after surgery. This paper describes this simple and rapid surgery and discusses some new, previously unpublished considerations and tricks.