Treatment for Pseudoptosis

Breast Droop

Breast Lift Surgical Options
After pregnancy, nursing, major weight loss, or just after years of exposure to gravity, the skin covering of the breast may become overly large for the amount of breast tissue left inside it. The breast then sags, producing skin contact between the lower breast skin and the chest wall. The medical term that describes this situation is breast ptosis.

Ptosis (Pronounced "toe\' - sis")(The "P" is silent) is the medical word for sag or droop.

Ptosis is the noun. The adjective form is ptotic.(Pronounced "taw\' - tic")
Breast ptosis is classified by comparing the nipple location on the breast mound to the location of the lower breast skin fold on the chest wall. The degree of ptosis varies from one patient to the next, and is subdivided into 4 grades of severity: pseudoptosis, grade 1 ptosis, grade 2 ptosis, and grade 3 ptosis.

Pseudoptosis

Pseudoptosis occurs when the lower breast gland tissue falls below the lower breast skin fold, but the nipple remains above the fold. Pseudoptosis may be treated by breast augmentation alone, by an eyebrow/crescent lift plus implant or by a circle nipple lift plus implant. Click on the View Photos button to see photos of people with this grade ptosis and how their procedures turned out.

Treatment of Pseudoptosis by Eyebrow/Crescent Nipple Lift

The eyebrow/crescent lift is accomplished by removing a crescent shaped piece of skin from the upper edge of the areola. When the edge of the areola is stitched to the skin edge above the areola it lifts the nipple position on the breast mound. The maximum amount of skin that can be removed without puckering and distortion is 2 cm because the upper skin migrates downward to the same extend that the areola skin migrates upward, the amount of nipple lift that can be acheived with this procedure is approximately 1 cm.

The advantage of this procedure is the very minimal scarring that results. It is most usefull when combined with placement of a breast implant. When combined with a breast implant, best results are obtained by placing the implant above the muscle in the subglandular position.

Treatment of Pseudoptosis by Circle Nipple Lift

Before surgery, with the patient standing at the bedside, an ideal location is selected for the postoperative position of the nipple. This is usually midway between the inner and outer edges of the breast, at the level of the lower breast skin fold. A line is marked 2 centimeters above the new location for the nipple.
A second line is marked on the lower breast, 7 centimeters above the lower breast skin fold. If the distance from the nipple to the lower breast skin fold is less than 7 centimeters, the second line is marked 1 centimeter below the lower edge of the areola.
A circle is drawn around the nipple and areola, including the upper and lower marks in the circle.
After the patient is asleep in surgery, the skin between the outer edge of the areola and the inner edge of the previously drawn circle is removed.
A pursestring suture is placed around the edge of the outer circle
The pursestring suture is drawn tight and tied. This reduces the outer circle to the same diameter as the areola, and produces an empty hole centered around the ideal new location for the nipple.
Suturing the outer edge of the areola to the inner edge of the empty hole completes the procedure. The skin around the pursestring suture is often puckered for a few months after the procedure.
After 6 to 12 weeks of healing time, the skin puckering around the edge of the areola flattens out, leaving a smooth breast surface contour. The thin scar is well camouflaged by the color contrast between the darker areola skin and the lighter-colored skin of the surrounding breast.

Below are four spreadsheets listing the measurements of patient's with Grade II Ptosis. Each spreadsheet lists patients who were treated with one of the four methods available for treating Grade II Ptosis. Within each treatment category, the patients are arranged from smallest to largest ribcage and shortest to tallest within the same ribcage circumference groups. To find photos to fit your starting situation, measure the circumference above your breasts and find that number on this chart under the ribcage size column, under circ. above. If there are several listed with that circumference, refer to the height section and find your height and then follow that line all the way over to the right and click on see photos to bring you to that patient's photos. Be sure to keep breast shape in mind when considering if those photos are ideal to your starting situation. You can also look at other photos of people with the same circumference but taller or shorter if available.

Pseudoptosis Treated with Augment Alone

PATIENT DATA				RIBCAGE SIZE			BREAST SIZE				PTOSIS				AROUND BREASTS		BRA SIZE		OP	SIZE		COMMENTS
Age	Preg	Ht	Wt	Circ.	N to MLN		Width		N to IMF		SN to IMF -SN to N		Ct Pt - IMF		Before	After	Before	After		CC
Age	Preg	Ht	Wt	Above	R	L	R	L	R	L	R	L	R	L	Before	After	Before	After		R	L
26	1	65	111	31	10	10	13	13	8.3	7.9	1.9	1.4	1.2	1.2	32.5	35.5	34B	34D	IMSG	360	360	See Photos
20	2	64	123	32	9.7	11	13	11	7.2	7.4	1.8	1	0.4	0.6	32.5	34.5	34C	32DDD	PASG	550	550	See Photos
49	2	68	136	32	8.7	10	13	13	22.9	22.8	1.7	0.2	2.6	2.7	33	34.75	34B	34C	IMSG	420	360	See Photos
27	2	65	130	32.5	10	10	15	15	8.1	9.3	2	1	1.7	3	33.5	38	34B	34DD	IMSP	600	600	See Photos
26	1	71	135	32.5	11	10	14	14	7.9	8.4	1.1	1.8	0.9	0.7	33.5	35.5	34C	34DD	IMSP	375	375	See Photos
39	1	61	119	33	9	9.8	14	13	6.3	7.5	1.7	0.7	1	1	34.5	37	38A	36C	IMSP	420	360	See Photos
31	2	64	125	33	8.5	9	13	12	6.9	6.9	1	1.3	2.2	2.2	33.5	33.75	34A	36C	IMSG	420	420	See Photos
33	2	67	135	33	9	9	11	11	5.8	5	1.8	1.2	0.9	0.3	33.25	36.25	32A	34C	IMSP	360	360	See Photos
44	2	65	130	33.25	9	8	14	13	6.5	7	0.7	-0.3	1.1	1.7	33.5	34.2	34B	34C	IMSP	375	375	See Photos
40	3	62	125	33.5	8.7	9	13	14	9.2	8.5	1.6	1.1	0.9	0.4	35.75	38	34B	34C	PASP	275	325	See Photos
34	3	61	118	34	10	10	15	15	8	7.2	0.9	0.6	1.9	2.2	35.25	39	34A	34D	IMSP	450	450	See Photos
25	3	62	130	34	10	10	14	14	5.8	6.2	1.1	0.8	-	1	34	36.5	34A	36CD	IMSP	450	400	See Photos
29	2	65	120	34	11	11	14	14	7.8	7.8	0	0.5	1.8	1.8	34	39.5	34B	34D	IMSG	450	450	See Photos
44	1	67	130	34	10	8.4	13	13	7.5	7.5	0.9	0.3	1	1	34.75	38	34B	36B	IMSP	420	420	See Photos
43	0	62.5	130	35.25	11	10	16	14	8.8	10	0	-1	2	2	36.75	40.1	34C	34D	IMSP	400	400	See Photos
27	3	72	175	35.5	12	11	15	14	5.7	5.5	0.3	1.2	0.9	0.9	36	39.25	36A	36D	PASP	500	500	See Photos
30	2	63	124	35.75	11	9.7	15	15	9.5	9	0.2	-0.4	2.8	2.2	37.25	36.25	34B	34C	IMSG	300	300	See Photos
41	1	65	125	36	10	11	15	15	9	9	1.4	1.1	1.3	1.3	36.25	38.75	36B	36D	PASP	420	420	See Photos
44	2	68	140	38.25	10	10	16	16	7	7.2	0.7	0.7	0.4	0.5	39	43.25	34B	36DD	IMSP	450	450	See Photos
35	2	68	160	38.75	10	9.7	14	14	6.4	6.5	0.2	-0.6	1.3	1.5	39	40.25	34A	38C	IMSG	450	450	See Photos
43	2	70.5	162	39.5	11	11	16	17	9.1	10.1	1.9	2.7	0.3	0.3	40.75	43.25	36C	38CD	IMSP	480	480	See Photos

Pseudoptosis Treated with Eyebrow/Crescent Nipple Lift

PATIENT DATA				RIBCAGE SIZE			BREAST SIZE				PTOSIS				AROUND BREASTS		BRA SIZE		OP	SIZE		COMMENTS
Age	Preg	Ht	Wt	Circ.	N to MLN		Width		N to IMF		SN to IMF -SN to N		Ct Pt - IMF		Before	After	Before	After		CC
Age	Preg	Ht	Wt	Above	R	L	R	L	R	L	R	L	R	L	Before	After	Before	After		R	L
36	3	66	125	33.25	9.8	9.8	14	13	6.6	6	1	1	0.6	0.6	34.5	37.25	34B	34D	EXSP	375	375	See Photos
26	2	67	135	34.75	9.5	10.1	12.0	12.0	4.9	5.3	1.1	0.4	0.9	0.9	34.75	36.5	34A	36C	EXSP	400	400	See Photos

Pseudoptosis Treated with Circle Nipple Lift

PATIENT DATA				RIBCAGE SIZE			BREAST SIZE				PTOSIS				AROUND BREASTS		BRA SIZE		OP	SIZE		COMMENTS
Age	Preg	Ht	Wt	Circ.	N to MLN		Width		N to IMF		SN to IMF -SN to N		Ct Pt - IMF		Before	After	Before	After		CC
Age	Preg	Ht	Wt	Above	R	L	R	L	R	L	R	L	R	L	Before	After	Before	After		R	L
27	2	64	114	30.5	11	10	13	13	6.3	6.3	1	0	-	-	32	35.5	36B	34C	CXSG	390	390	See Photos
26	1	63	111	32	12	11	13	13	8	8	1	0.2	-	-	33.5	34	32B	32C-D	CXSG	375	375	See Photos
40	3	64	125	33.5	9.4	9.4	14	14	5.3	5.9	0.3	-0.2	0.7	1.7	33.75	36.5	34B	34D	CXSP	390	390	See Photos
36	5	61	110	34	9	9.6	15	14	5	5	0.2	-1.4	1.1	1.4	34.1	37.5	36A	38D	CXSP	420	420	See Photos
28	3	67	134	34.25	10	10	13	13	7.1	7	0.8	0.5	2.7	1.8	34.25	35.25	36A	34C	CXSP	390	390	See Photos
34	2	64	136	35	11	11	16	16	9.5	9.5	0.7	0.8	1.7	2.3	37	39.5	38B	38C	CXSG	300	300	See Photos
36	2	64	136	35.75	9.9	8.9	15	15	7.2	7.2	0.3	-0.6	1.4	1.2	35	38.5	34B	36D	CXSP	450	450	See Photos
42	1	64.5	138	36.25	11	11	15	15	7.4	7.4	0.7	0.7	1	1	37.25	39	34A	34C	CXSP	240	240	See Photos
25	1	68	170	36.75	12	11	14	14	7.2	7.2	0.4	1.6	-	-	38.5	39.25	36A	36D-DD	CXSG	550	550	See Photos
43	2	69	160	36.75	10	10	14	14	7.4	7.4	0	-1.5	2.1	2.5	37.75	40	36B	36D	CXSP	420	420	See Photos

Pseudoptosis Treated with T-Lift

PATIENT DATA

RIBCAGE SIZE

BREAST SIZE

PTOSIS

AROUND BREASTS

BRA SIZE

SIZE

COMMENTS

Age

Preg

Circ.

N to MLN

Width

N to IMF

SN to IMF -SN to N

Ct Pt - IMF

Before

After

Before

After

Above

143

35.25

9.9

10.5

10.3

0.6

-3.8

2.3

3.8

36.5

39.5

34D

38D

TXSP

360

See Photos