A classification and algorithm for treatment of breast ptosis

BACKGROUND: The Regnault classification of breast ptosis is insufficient for determining surgical strategies for different stages of ptosis. OBJECTIVE: A new clinical classification of breast ptosis is proposed that allows greater precision in the development of an appropriate surgical plan. METHODS: Breast ptosis is classified in 1-cm stages, beginning with stage A at 2 cm above the inframammary crease and continuing through stage E at 2 cm below the inframammary crease, with any level of ptosis beyond stage E defined as stage F. Increments of 1 cm were chosen because each level predicts a different amount of skin excision necessary to elevate the nipple-areolar complex to an ideal aesthetic level. An algorithm is provided for defining options for surgical management of the ptotic breast with and without augmentation and for the previously augmented breast. RESULTS: Seventy-three cases of breast ptosis were treated with augmentation mammaplasty, simultaneous areolar mastopexy breast augmentation, Wise mastopexy breast augmentation, and other procedures following the proposed classification system and treatment algorithm. CONCLUSIONS: The new system for staging of breast ptosis is simple and easy to remember and can assist in the planning and evaluation of surgery. (Aesthetic Surg J 2002;22:355-363.).