Mastopexy With Mesh for Breast Ptosis

Synopsis

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  Different classifications of breast ptosis have been put forward by Regnault and Kirwan, depending on the extent of the nipple-areola complex (NAC) descent below the submammary fold.

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  The surgically corrected ptotic breast must be supported internally to prevent recurrence.

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  Implants can help in marginal ptosis.

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  An internal bra mesh system (Breform, Triangle Surgical, Buckinghamshire, England) is indicated for women who are having no more children, with acceptable breast volume, who are not seeking augmentation.

The Aesthetic Problem

Breast ptosis occurs when the supporting structures of the breast fail. Structures that support the breast relative to the chest wall include the ligamentous suspension, described by Wueringer and Tschabitscher, and the supporting ligaments, described by Matousek et al. The ligamenta suspensoria described by Cooper, stretching from the lobules to the skin, are responsible for breast shape but cannot support the breast relative to the chest wall; it was described very accurately in his book. The supportive function of the skin could be questioned because of the frequent recurrence of breast ptosis in techniques relying on the skin for postoperative breast support.