What are the characteristics of a ptotic or drooping breast?
The ptotic breast is characterized by inferior and lateral descent of the mammary gland and nipple-areola complex. In the early stages of ptosis, both descend at the same speed. However, in the later stages there is a greater descent of nipple and areola than of the gland. So this is placed face down, instead of being centered at the point of maximum projection of the breast, as in the young breast.As the breast tissue moves down, the upper area of the breast becomes flatter with a significant loss of volume. The skin becomes redundant, lax and inelastic and the breast has a considerable increase over the chest wall.
What factors contribute to breast ptosis?
While undoubtedly big breasts show a certain degree of ptosis, this is more related to a combination of volume loss and deterioration of skin support. Commonly, the first is a result of significant weight loss, postpartum atrophy or postmenopausal involution. Gravity exerts a steady ptotic pull on the breast lengthening the ligaments that support it and stretching the skin. Very large and heavy breast prostheses contribute to ptosis. Skin quality is influenced by several factors, including aging. When the skin gets thinner, the natural support stops working and brest droops.
What are the goals of mastopexy?
Mastopexy is a surgical procedure that attempts to reverse the normal progression of breast ptosis, thus restoring a more youthful breast shape. In fact, some breats never have an appearance of fullness without ptosis not even during youth. For treatment of breast ptosis not only abnormal features of the patient’s breast are important but also her hopes and expectations.
The goals of mastopexy are: repositioning the nipple-areola complex and the mammary gland, optimizing its contour and volume, removing excess skin and tightening the skin support and breast provide lasting supporting. The mastopexy techniques that have been developed in parallel with developments in breast reduction procedures are also used to treat congenital defects (tuberous or tubular breasts), correct asymmetries (congenital or acquired) and optimize the cosmetic results after removing implants in augmented breasts.
Are the effects of mastopexy permanent?
No. As soon as this process is completed, the ptotic forces such as gravity and aging restore their relentless attack on the breast.
What are the main disadvantages of mastopexy?
- Mastopexy requires incisions being made on the breast and they are sometimes very large depending on the technique used.
- The effects of surgery are only temporary and can be repeated over the years if necessary.
- The skin of these ptotic breast is often very thin, of poor quality and lack of elasticity, which is a bad support for the breast and sometimes has decreased blood supply, which may result in a delay in healing.
- The flattening of the upper area of the breast can not be filled simply with mastopexy, so sometimes we need to associate the placement of an implant to correct it.
- Although mastopexy provides more lifted breast, as we reposition the breast tissue and remove excess skin the breast will look smaller. This problem is also solved by placing an implant.
What are the advantages and disadvantages of implant placement associated with a mastopexy?
The size and the breast contour may increase and improve with the addition of an implant. Interestingly, this also increases the longevity of the effects of the mastopexy and often reduces the extent of necessary scars for proper surgery. However, the wrapper of a ptotic breast skin may not be able to adequately support the weight and possible expansion of an implant. So it is advisable to use a implants of moderate volume and weight. The elevated breast without the use of an implant may also lose some degree of projection as well as or volume in addition.