Relationship Between Breast Density and Ptosis Degree in Direct-to-Implant Breast Reconstruction

Direct-to-implant breast reconstruction is a popular procedure since breast volume can be acquired immediately. Various evaluations have been utilized to achieve symmetry. We measured the weight and volume of mastectomy specimens and calculated the relationship between breast density and ptosis degree.

We conducted a retrospective chart review of patients who had undergone direct-to-implant breast reconstruction. Clinical data from 155 patients were reviewed, and they were classified based on breast density (weight/volume) (Group 1: density < 0.9 g/mL [n=17], Group 2: 0.9 g/mL ≤ density <1.1 g/mL [n=59], and Group 3: density ≥ 1.1 g/mL [n=79]). The relationship between breast density and ptosis degree was analyzed using the Cochran-Armitage test for trend. Adequate suture and anchoring techniques were applied to achieve symmetric breasts. Postoperative outcomes were assessed by measuring the discrepancy in nipple height.

A statistically significant relationship was found between higher breast density and a greater degree of ptosis. The outcome showed a significant trend across Group 1, 2 and 3 (p<0.05). In postoperative analysis, the nipple level discrepancy was less than 10 mm as follows: 100% in Group 1, 89.8% in Group 2, and 70.9% in Group 3, showing a progressive decreasing trend from Group 1 to Group 3 (p<0.05).

Direct-to-implant breast reconstruction is an attractive technique, offering predictable outcomes based on adequate measurements. The relationship between breast density and the degree of ptosis is a significant indicator in making intraoperative decisions. Breast density is an adjunctive index for achieving patients' expectations of symmetrical breasts.

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