Background: Periareolar Augmentation Mastopexy is one of the most challenging operationsin plastic surgery. Problems with scar quality, areolar widening, and distortion are frequentproblems that interfere with a predictable result. Methods: A retrospective review was performed on fifty consecutive patients who underwenta periareolar augmentation mastopexy with the interlocking approach. Of the 50 patients, 30had both preoperative and postoperative photographs and were the basis of the study. Results: The age of the patients ranged from 19 to 56 years with the average age being 39years. The postoperative follow-up averaged 9.5 months and the implants averaged 316 mL. There were no deaths, pulmonary embolism, deep vein thrombosis, or infected implants. Fourpatients had complications following surgery for an overall complication rate of 13%. Twopatients developed an infected Gore-Tex suture. Two of these complications were treated withrevision surgery. Five patients required reoperation for an overall reoperative rate of 16% (onepatient was converted to a full mastopexy). Conclusions: As a result of this retrospective study, we have found the interlocking approachto periareolar augmentation/mastopexy to be a safe and reliable operation.