NORMAL BREAST ANATOMY
General breast anatomy is covered in the breast augmentation section.
ANATOMY OF THE SAGGING BREAST
The medical term for sagging breasts is mammary ptosis. In the sagging breast there is too much skin for the amount of volume. Not only does the skin cover a larger area, but it is thinner and less elastic. The skin is also weaker and that is why it is unable to support the weight of the breast. Often the skin will show stretch marks (stria) which are tears in the deeper layer of the skin (dermis). Within the breast, the tissue has become more mobile and less cohesive or compact. The supporting ligaments of the breast are also stretched.
As a result of these internal and skin surface dynamics, the appearance of the breast is changed. The nipple and much of the breast gland hang over the inframammary fold. With this redistribution of volume the upper portion of the breast becomes flattened. The nipple sits low on the breast and is a longer distance from the landmarks of the upper chest such as the collarbone. Also just under the breast there is increased contact between the breast skin of the lower portion of the breast and the chest wall skin. This can often cause rashes and irritation.
CLASSIFICATION OF MAMMARY PTOSIS
There are varying degrees of mammary ptosis (sagging).
Minor ptosis – nipple at level of inframammary fold.
Moderate ptosis – nipple between the level of the inframammary fold and the lowest point of the breast.
Major ptosis – nipples at bottom of breast pointing downward; most of breast tissue below the inframammary crease.
Glandular ptosis – nipple above fold; some of the gland below the fold.
Pseudoptosis – nipple above fold; very little volume left, most of which sits below fold.