Problems with periareola or circumareolar mastopexy procedures include areola spreading, hypertrophic scar, and recurrence of the ptosis largely because of tension on the closure. To minimize this tension associated with a conventional crescent mastopexy procedure, the authors modified the operation by excising parenchyma with the crescent of skin as well as two small triangles of parenchyma on either side of the areola. Implant augmentation was performed at the same time. The described operation is indicated for patients who have a small to moderate amount of ptosis. The best candidate is the patient whose areola-inframammary distance is not excessive. Nine such patients received this "extended crescent mastopexy with augmentation" and were followed for up to 3 years. Areola spreading and hypertrophic scar were kept to a minimum. Although not the final answer for ptosis patients, the extended crescent mastopexy with augmentation has been a step in the right direction.
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