BREAST PTOSIS

Everyday, more women go to our practices in order to 'fix their breasts' after pregnancy. The most common complaint is that the breasts seem to be sagging, shapeless and empty.

During pregnancy and lactancy, a marked increase of the mammary gland and of skin takes place. Once the hormone process is over, there is a gland's involution, it atrophies so a loss of breast volume occurs. However, it does not happen the same to the skin since the involution is smaller. Moreover, there is a ligament distension that also provokes sagging. According to the position of the gland regarding the areola and submammary line, we distinguish three kinds of ptosis (technical term for sagging breasts). The chosen technique depends on the position of the areola-nipple, and also on the residual gland's volume and remnant skin.

In most of the cases, we use a technique combining a skin resection plus breast augmentation. The scar left thereafter is one of the problems that most worry both doctors and patients. Personally, I try hard no to leave a conspicuous scar. But, what else can be done?

If the patient desires a combination with breast augmentation, the best technique for a natural result is to remove the skin around the areola so that we only leave a scar around it and we place a silicone implant. The implant provides volume, especially in the bosom or neck area and we do not need to remove a larger amount of skin. In order to get the best results regarding a natural shape, I prefer to place the silicone just under the upper half ot the pectoral muscle. Thus, the bosom looks nicer and there is less risk of encapsulation.

If the patient does not want a breast augmentation, the technique is different and we try to remodel the gland from within, in order to place it in its original position, to provide projection and a younger aspect. Depending on the areola's position, we remove just the skind around it or in more severe cases, we have to perform a vertical scar from the areola to the line. This scar is visible during the first months but then it turns hardly noticeable. It is a modified technique from that of breast reduction, but without removing the gland.

This surgery is undertaken with general anaesthesia, it lasts between 90 and 120 minutes and it requires an overnight stay. Then, the patient has to wear a bra night and day so the gland cicatrizes in its new position.