Preservative Breast Augmentation: Preserving Muscle-glandular unions by areolar approach.

Background: Breast augmentation remains one of the most commonly performed cosmetic surgical procedures worldwide to achieve a youthful and beautiful breast appearance. We describe a technique that preserves glandular tissue and muscle-glandular junctions of a submuscular pocket through a periareolar approach, providing stable implant coverage. Methods: Prospective data collection of all patients with mild and moderate breast atrophy who underwent the preservation breast augmentation technique were included, and procedures were performed from February 2019 to August 2021. Demographic characteristics and peri- and postoperative variables were collected. Results: Sixty-four patients were included in the study. The mean age at the time of the breast augmentation surgery was 26 years. The size of the breast implants used ranged from 275 to 375 cc. At one year postoperative follow-up only one patient required surgical correction for breast asymmetry and another patient experienced a self-resolving subcutaneous hematoma. No infections or wound dehiscence was observed. Sensation in both breasts was normal in all patients at the two-month mark, surgical results were deemed satisfactory according to the BREAST-Q score, and the BAKER score for all patients was one. Conclusion: Preserving the anatomy and function of the glandular muscle unit leads to the preservation of the breast glands and the creation of more stable sub-muscular mammary pockets. This results in implants with greater muscle-glandular coverage throughout their entire extent and significantly reduces glandular atrophy. These advantages distinguish the technique and make it highly reproducible, with a short learning curve.