This is accomplished by leaving attached underlying breast tissue, which supports the blood supply to the nipple areola complex and wrapping it in a tightened skin envelope. Results are usually excellent in the immediate postoperative period. Unfortunately with time, gravity causes the breast tissue to drift downward stretching the skin, creating recurrent sag.
This phenomenon is known as bottoming out of the breast and not only results in sag, but loss of the upper breast fullness as well. This phenomenon is more likely to occur if the patient has thin skin. The amount of sag that the patient has preoperatively and how much breast tissue is left behind are also factors.
In an effort to minimize the development of recurrent sag and loss of upper breast fullness, surgeons have utilized various maneuvers. Positioning of the breast pedicle to a more superior location has been found to be helpful. Internal suture techniques have been utilized as well. Despite modifications in surgical technique, loss of upper breast fullness may still occur. Despite your surgeon’s best efforts, it’s important to realize that gravity is an unrelenting force.
