Periareolar
Mastopexy Corrects Ptosis Without Scarring
by Robert M. Freund, M.D.
Patients
who exhibit self-consciousness about the appearance of their
breasts, or who no longer consider their breasts aesthetically
pleasing, should be considered candidates for periareolar
mastopexy, rather than a more traditional surgical approach.
With this safe and effective surgical breast lift, the incision
is made around the areola and heals to produce no noticeable
scar. In addition, mastopexy addresses both causes of breast
ptosis-the droopiness created externally through the stretching
of the skin envelope and the droopiness created internally
through the stretching of tissue fibers. Many techniques
today do not address the internal cause of ptosis and rely
solely on skin excision to lift the breast.
Studies show that mastopexy provides excellent results and
minimal complications. The surgery provides a long-lasting,
natural look for patients with hypertrophic breasts who
complain of back pain and seek reduction surgery.
CLASSIFICATION
The normal breast is located between the second intercostal
space and the sixth rib. When the volume of the breast is
small and well supported by the skin envelope, no submammary
fold is formed.
In the young female the nipple lies at the center of the
gland and in front of the fourth rib. In the aesthetic mature
breast, it lies slightly below the center of the breast,
in front of the fifth rib.
Normally, the nipple, skin and gland follow the influence
of gravity together. They descend at the same time; the
distance of the nipple to the submammary fold increases
very little while the distance of the nipple to the clavicle
elongates.
Such is not the case in the ptotic breast. Ptosis may present
in varying degrees and may be distinguished according to
the relationship of the nipple to the submammary fold.
DEGREES
OF PTOSIS
· First degree (minor ptosis) – the nipple lies at
the level of the submammary fold, above the lower contour
of the gland and the skin envelope
· Second degree (moderate ptosis) – the nipple lies
below the level of the fold but remains above the lower
contour of the breast and skin envelope
· Third degree (major ptosis) – the nipple lies below
the fold and at the lower contour of the breast and skin
envelope
· Pseudoptosis – the nipple is above the fold but
on the lowest part of the brea