The correction of ptotic breast

Introduction

Breast ptosis is caused by volume envelope discrepancy as a result of pregnancy, lactation, weight loss, and aging. Although surgical grading according to nipple level help the correction, in the viewpoint of the patient, ptotic appearance of the breast means various status from small flat skinny sagging breast to huge breast.

Characteristics of the ptotic breast:

In general the ptotic breast has some characteristics such as lower position of nipples, excess of envelope, lack of breast parenchyma, highly mobile parenchyma mainly due to loosening of subglandular space or failure of Cooper’s ligament action as supporters and well defined inframammary fold

Methods

Patient oriented treatment is not simple and we have to manage ptosis with considering many things such as patient physical condition, patient’s demand about size and shape, scar, and realistic expectation.

Ptosis can be improved by simple augmentation with implant into the dual plane or retroglandular plane or fat graft.  If nipple is located 2cm below inframammary fold, mastopexy is more reliable and sometimes simultaneous augmentation mastopexy is needed.

The most appropriate correction method is not easy to decide, however it can be chosen if we  consider several things such as patient physical condition, patient’s demand about size and shape, scar, and realistic expectation.

I would like to give presentation about my various experiences. 

또한 중국사람들에게는 생소한 배꼽을 통한 가슴확대술을 강연하였습니다.

Operative Procedure of TransUmbilical Breast Augmentation

Jin-Seok Park, MD, PhD

Parkjs Aesthetic Clinic

There have been many improvements since transumbilical breast augmentation(TUBA) was introduced first in 1993. Although patients who want the cohesive gel implants are increase, some portion of patients still want the saline implants due to small remote scar and/or hatred for gel implants.

As my 14 years experiences, TUBA has several benefits for Asian women such as remote less visible scar, less pain, shot operation time, rapid recovery, and so on.

Operative procedure goes on regional block, tunneling, inserting sizer, making pocket,  inserting implants and dressing. This procedure is generally little painful. If patient feel pain, you have to check up your procedures such as local infiltration efficiency, bleeding, too much tension. Muscle clamping pain can be reduced by muscle relaxants such as Metocarbamol. This procedure is Less bleeding tendency in contrast with other blind procedures, if not, you have to check several points such as sufficient local infiltration & waiting, tunneling through abdominal fatty layer (neither subdermal, nor suprafascial), making pocket by stretching not tearing tissue and not leaving the space vacant. And The operation time is short as 30 minutes are enough from incision to closure So you don't have to hurry.

Transumbilical breast augmentation is not the best procedure however very useful  technique for some candidates.