In Greek terminology, Ptosis literally translates into ‘a falling.’ With respect to the human breast, ptosis refers to a change in breast shape that results from descent of the nipple-areolar complex below the level of the lower breast fold (i.e inframammary fold or IMF). That is, breast sagging. In the plastic surgery nomenclature, there is a common classification system that is relatively easy to understand:
1) 1st degree/mild ptosis: the nipple position lies within 1cm of the IMF.
2) 2nd degree/moderate ptosis: the nipple position lies 1-3 cm below the IMF, but is still on the anterior projection of the breast mound.
3)3rd degree/major ptosis: the nipple position lies below the IMF, and is on the dependent portion of the breast mound.
Surgical treatment of breast ptosis varies based on the degree of deformity. Appropriate treatment ranges from breast augmentation with implant, to mastopexy alone, to combined mastopexy- augmentation. For patients who have lost a significant amount of weight (massive weight loss) from diet modification, exercise, or bariatric surgery the type and degree of breast deformity is quite different, and is more consistent with a “maldistribution” of the breast tissue.