Treatment of pseudoptosis

Abstract

The breast changes as a result of aging, weight, fluctua-tions in weight, pregnancies, and breastfeeding. Sagging of the glandular body, breast envelope, and the nipple-areola complex (NAC) normally occurs synchronously and is described by Renault's Grade I to III ptosis classification. This classification describes the changes seen in the majority of breasts. The length of the thorax and the height of the SMF are, for the most part, not taken into account. Thus only absolute measurable parameters such as the distance of the nipples from the sternal notch provide signs of changes that are regarded by the observer as harmonious (pleasing to the eye) or disharmonious. Changes to the three criteria, glandular body, envelope, and height of the NAC, may occur asynchronously, although this is not frequent. This typically results in pseudoptosis and glandular ptosis or sagging of the breast following surgery (bottoming out). In the case of pseudoptosis, only the volume of the breast changes, that is, the glandular body becomes smaller. The envelope and position of the NAC remain unchanged. Consequently, the upper half of the breast becomes concave in shape, the projection of the breast is reduced, and the lower half of the breast loses elasticity and thus sags without there being an increase in the nipple to submammary fold (N-SMF) distance. It looks like ptosis, but in fact is not. With glandular ptosis, on the other hand, the volume, that is, glandular body, and the position of the NAC are both stable, while the envelope in the bottom section increases in length and bulges downward. N-SMF distance has increased. The same changes occur with so-called bottoming out, in particular, following surgery using the inverted T technique and other mastopexy techniques, although this is less frequent. © 2009 Springer-Verlag Berlin Heidelberg.