Breast sagging not only detracts from a woman's body contour but, more seriously, can cause feelings of inferiority and affect mental well-being. Some individuals experience significant sagging in one or both breasts, leading to mobility issues, neck and shoulder discomfort, and skin irritation or eczema in the breast folds. Therefore, corrective treatment is essential.
Breast ptosis is classified into three degrees based on severity:
Grade I: Ptosis where the nipple aligns with the breast's natural fold line.
Grade II: Ptosis where the nipple lies below the fold line but above the lowest point of the breast.
Grade III: The nipple is at the lowest point of the breast. However, in some cases of breast ptosis—particularly those with hypertrophy in the distal breast—the nipple may not be at the lowest point despite significant ptosis. Such cases should also be classified as Grade III.
Who requires breast ptosis correction?
(1) Individuals seeking cosmetic improvement for any type of breast ptosis.
(2) Individuals experiencing physical symptoms from ptosis, such as shoulder, back, or chest pain, or erosion of the inframammary fold.
(3) Individuals whose occupation requires a certain appearance, such as fashion models or athletes, and ptosis affects their professional image.
How is breast ptosis correction performed?
For mild to moderate ptosis, the traditional approach involves a periareolar incision. Above this incision, a crescent-shaped segment of skin and subcutaneous tissue is excised, allowing the nipple-areola complex to be elevated and sutured in place. Alternatively, treatment may follow the protocol for severe ptosis. Severe ptosis typically requires a breast reduction procedure, comprising three fundamental steps:
① Elevating the nipple-areola complex;
② Reshaping the glandular tissue;③ Reducing the skin envelope. These methods are well-documented in the literature and will not be elaborated upon further in this section.
The buried guide suture needle, offering two suturing opportunities, enables suspension fixation of sutured tissue to deeper structures through small incisions in areas unsuitable or inaccessible for skin incisions. This makes it particularly suitable for treating mild to moderate breast ptosis. The method is described below:
1. Incision Design for Breast Ptosis Correction: Design an incision encircling the areola, measuring 1/2 to 2/3 of the areolar circumference.
2. Incision and Dissection: Incise the skin and subcutaneous tissue along the planned incision. Sharply dissect a skin-subcutaneous tissue flap over the mammary gland surface, extending to the junction of the mammary gland base and pectoralis major muscle, corresponding to the second intercostal space.Breast Ptosis Correction Suture Suspension: Using a buried guide needle, insert 3-0 absorbable suture through the incision. Pass the suture through the deep pectoralis major muscle at the 12 o'clock position in the second intercostal space, exit through the skin, and redirect the needle tip to exit through the dissected flap space. This securely anchors the 3-0 absorbable suture to the pectoralis major muscle.
Next, locate one or multiple suitable points along the vertical axis at the 12 o'clock position within the mammary gland. Secure the suture with an appropriate knot to achieve elevation of the nipple-areola complex. Repeat this technique at the 11, 1, 10, and 2 o'clock positions using the buried guide suture needle to suspend the mammary gland until satisfactory correction of breast ptosis is achieved.
4. Incision closure for breast ptosis correction: Subcutaneous tissue is closed with interrupted 6-0 absorbable sutures, and the skin is closed with interrupted 3-0 silk sutures.
5. Place drainage strips and apply routine dressing.