Mastopexy with Autoprosthesis

Abstract

Mammary ptosis is generally characterized by breast sagging with its parenchyma drooping to the bottom of the skin envelope and, consequently, leaving an empty upper pole. Furthermore the nipple-areola complex (NAC) can shift downwards by various degrees. In order to better frame mammary ptosis, the authors have proposed a simple and effective classification, in which both the breast contents (parenchyma, fat, connective tissue) and the NAC position are taken into consideration. These are the two main data on which the choice of the surgical technique should be based. When the breast leans on the chest skin by about 1 cm, this is indicated as Par (parenchyma) = 1; when the breast leans between 1.5 and 2.5 cm (around 2 cm), it is called Par = 2; Par = 3 between 2.5 and 3.5 (about 3 cm) and Par = 4 beyond 3.5. If the NAC position is about 1 cm below the inframammary fold, we pinpoint it as NAC = 1; if the NAC is between 1.5 and 2.5 (about 2 cm) below the IMF, we call it NAC = 2; from 2.5 to 3.5 (about 3 cm), it is NAC = 3; beyond 3.5 it is NAC = 4. This classification helps a lot to better define the ptosis and to establish the treatment. It gives the possibility to immediately get the picture, and therefore it can be quite precious in any medical referral or debate (Figs. 13.1 and 13.2).