Breast Ptosis

What is Ptosis?

Ptosis is a medical condition that refers to the drooping of a woman’s nipple, areola, breast skin and/or elongation is due to tissue stretching, atrophy (degeneration), or a loss of elasticity. The change is classified as ptosis when the breast has become significantly elongated in comparison to the adolescent breast.
Ptosis sometimes occurs with early breast growth, during a woman’s developmental phase, but is more common over time. Advanced age and lifestyle factors (weight loss or pregnancy) contribute to the development of ptosis. It also occurs as the result of gravity, hormonal changes and after glandular regression (an element of menopause).

What is Pseudoptosis?

Pseudoptosis refers to a condition where the nipple remains in a normal position, which is usually about 21 centimetres from the sternal notch (the hollow right at the base of the neck) in the average woman, but a significant amount of the breast gland sits below the inframammary crease or fold (the fold under the breast). This positioning indicates the presence of glandular ptosis — referred to as pseudoptosis. Pseudoptosis is usually treated through breast augmentation with implants and the lowering of the inframammary fold rather than complete mastopexy (breast lift).

Classifying Breast Ptosis

Physicians and surgeons typically determine degrees of breast ptosis using a system developed by a Canadian surgeon, Dr. P. Regnault, who created a classification method for the condition in 1976.
The Regnault classification system uses a set criteria that includes:

Pseudoptosis / Glandular Ptosis: the nipple is above the inframammary fold, but the breast hangs below the fold (as described above).

Minor Ptosis (Grade I or 1st Degree): the nipple is at the level of the inframammary fold.

Moderate Ptosis (Grade II or 2nd Degree): the nipple is below the inframammary fold, but above the lower breast contour.

Severe Ptosis (Grade III or 3rd Degree): the nipple is below the inframammary fold and also below the lower breast contour.

Each of the Regnault classifications includes the basic criteria of the patient having a stretched breast envelope. Physicians further classify the patient (while also considering their correction desires and the quality of their skin) in order to recommend the most effective form of treatment.

In many cases, patients suffering from minimal ptosis (pseudoptosis/glandular ptosis and minor ptosis) can be effectively treated with breast implants. Women whose condition is classified as 2nd or 3rd degree on the Regnault scale require more extensive surgery and skin excision. Physicians and surgeons will always work with the patient to determine the best form of treatment for their individual circumstance and desires.




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