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Preoperative Evaluation

Patients who are in the routine breast imaging program should have their mammography / ultrasound examinations done.

Position of the nipple and the existing breast tissue quality are evaluated.  New location of the nipple and breast tissue is determined in the light of patient's desire and anatomic features.

Excess skin will be removed, ligamentous support will be restored and the tissues will be tightened .

Surgery involves excess skin is removal and internal tucking of the breast tissue.

Breast Crease Level

Main factors in determining the surgical technique are:

  • Body structure of the individual,

  • Amount and quality of breast and skin tissue,

  • Degree of sagginess (Ptosis level).

In an aesthetic and attractive breast, nipple is well above the breast crease. The majority of the breast tissue is located  above the fold.

Stage I

Nipple is at the level of the under-breast crease. Breast tissue is slightly shifted under the crease.

Stage III

The nipple is located 3 cm or more below the crease. Almost all of the breast tissue is under the fold. Nipple forms the lowest limit of the breast.

Stage II

Nipple is 1-3 cm below the fold. Breast tissue is located substantially below the fold.  

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Ptosis level is particularly important in determining the surgical technique to be applied .

Degree of sagging or level of ptosis is classified by the relationship between the breast crease and  the nipple.

Patients must be aware that a "slight" reduction in breast size will be encountered even after correction of mild ptotic breast. This is because of the internal tightening loose tissues together. Patients with moderate to severe ptotic breasts will encounter more reduction in size as they will require more tightening with removal of excess skin. This effect can easily be  simulated by gathering breast tissues together with hand .

 

If concomitant enlargement is also planned, the size of the silicone prosthesis to be placed is also determined . The use of a small and medium sized implants is very common. Tissue consistency and volume restoration may only be achieved by use of silicone implants, especially in patients with severely ptotic breasts and loose tissue firmness.

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