The classification system (suggested by Regnault and modified by numerous authors) is as follows:
Grade 1: Mild ptosis -
- Nipple just below inframammary fold but still above lower pole of breast
- Nipple further below inframammary fold but still with some lower pole tissue below nipple
- Nipple well below inframammary fold and no lower pole tissue below nipple; "Snoopy nose" appearance
- Inferior pole ptosis with nipple at or above inframammary fold; usually observed in postpartum breast atrophy
Some guidelines for surgical correction:
Minimal or minor breast ptosis
- can be corrected with breast implant augmentation.
- can be corrected with periareolar skin resection (around the nipple complexwith or without augmentation. (photo credit)
- Minor grade 2 can be corrected using a circumareolar donut mastopexy including the cerclage techniques as described by Benelli.
- Moderate grade 2 ptosis can be addressed using the vertical scar mastopexy procedures, including the Regnault B technique and Lejour/Lassus techniques. (photo credit)
Severe grade 2 ptosis and grade 3 ptosis
- This degree of ptosis usually requires inverted T incisions regardless of the pedicle used. (photo credit)
- can be addressed with augmentation and/or skin excision without nipple transposition (excision of lower pole skin) or with the circumareolar cerclage technique.
General complications can include bleeding, infection, and problems secondary to anesthesia.
Something to think about:
Breast Mastopexy by Jorge I de la Torre, MD--eMedicine Article
Breast Lift Mastopexy Videos and Movies Before and After Surgery Gallery--Michael Bermant, MD
Breast Lift (Mastopexy)--American Society of Plastic Surgeons
Photo of Grade 3 Ptosis, before and after correction, no implant--Dr R. V. Dowden
Surgery of the Breast: Principles and Art By Scott L. Spear--Google eBook (or purchase through Amazon.com)