There are degrees in the severity of the loss of shape (or “ptosis”) that is present from one patient to another and sometimes between breasts of the same patient. These changes are categorized as follows:
- Pseudoptosis: : The nipple is at a normal position but the breast has fallen out below it. This can happen after a breast augmentation where the pectoralis muscle has been released at the bottom of the pocket leaving the only support for the weight of the prosthesis the skin and subcutaneous fat.
- 1st degree ptosis: The nipple is at or slightly below the infra-mammary fold.
- 2nd degree ptosis: : Further sagging of the breast and lowering of the breast nipple on the chest. The nipples are usually pointed toward the floor.
- 3rd degree ptosis: This is the most severe. The breast is flat and sagging with the nipple at the lowest part of the breast.
What generally is not attainable with a breast lift or ptosis procedure? Generally it is not possible to obtain long lasting increase in upper pole fullness. The upper pole is the level at which the breast mound first begins. To have long lasting increase of upper pole fullness you need to add a breast prosthesis.
From a geometric or architectural standpoint the design of the surgical procedure should accomplish the following to give long lasting coning of the breast and give it projection forward from the chest wall and a 3 dimensional change:
- The base circumference of the breast base must be decreased.
- The nipple must be re-positioned.
- Breast tissue needs to be elevated and placed beneath the nipple.
The repair and tension should be carried within the breast tissue and not superficially in the skin and subcutaneous tissue. I believe my procedure accomplishes this with minimal incisions and scars.
The following are some questions commonly asked by patients:
Can I nurse if I become pregnant?
Only 60% of mothers can make enough milk to satisfy their babies without some other supplement. I would estimate you have a 50% chance of being able to nurse and satisfy your baby.
Will my new shape be ruined if I become pregnant?
There is no way anyone would be able to predict with certainty what your outcome would be. Some women’s breasts become quite large, some do not change significantly, some enlarge with one pregnancy and not the next. If you became quite large and then had postpartum breast involution, you could have some issues with your breast shape.
Will I lose my nipple sensation?
This is possible but has not occurred in any of my patients.
If my weight fluctuates will this affect the shape of my breasts?
If when you gain and lose weight and your breasts significantly change in volume this will have a deleterious effect on your breast shape.