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Breast Surgery

The abnormal breast

Breast asymmetry

Different volume, shape, or positioning of the breasts. 

Surgeries offered: Breast augmentation and/or reduction and/or mastopexy.

Pectus excavatum

Chest wall deformity where ribs and sternum grow abnormality, causing a concave appearance in the anterior chest wall.

Surgeries offered: Nuss’ procedure (a thoracic surgery procedure, where 1-3 steel bars are inserted under the sternum so that is pressed out into a normal position in 2-3 years), or a minor plastic surgery procedure, where a silicone implant is placed and/or fat grafting into the chest cavity over the sternum bone is performed.

East-west asymmetry’

Lateral nipple malposition where nipples point in opposite directions – often coupled with mild to moderate pectus carinatum (bird chest):

Surgery offered: crescent mastopexy, pocket revision, free nipple graft, and pedicled nipple transposition (2).

Breast ptosis

Figure 2. Grades of breast ptosis.

Medical term for drooping breast tissue. The degree is categorized by evaluating the position of the nipple relative to the inframammary fold (IMF):

Grade I (mild ptosis): Nipple at the level of the IMF and above most of the lower breast tissue.
Grade II (moderate ptosis): Nipple below the IMF but higher than most of the breast tissue.
Grade III (severe ptosis): Nipple below the IMF and at the level of maximum breast downwards projection.
Glandular ptosis/pseudoptosis: Nipple is located either at or above the IMF. The lower half of the breast sags below the fold. Often seen when a woman stops nursing, as her milk glands atrophy.

Surgeries offered for ptosis

Mastopexy (areolar or Wise pattern), augmentation or simultaneous mastopexy and augmentation (3).

References

1. Kolker AR, Collins MS. Tuberous breast deformity: classification and treatment strategy for improving consistency in aesthetic correction. Plast Reconstr Surg. 2015 Jan;135(1):73–86.

2. Small K, Kelly KM, Swistel A, Dent BL, Taylor EM, Talmor M. Surgical treatment of nipple malposition in nipple-sparing mastectomy device-based reconstruction. Plast Reconstr Surg. 2014 May;133(5):1053–62.

3. Kirwan L. A classification and algorithm for treatment of breast ptosis. Aesthet Surg J. 2002 Jul;22(4):355–63.

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