Nine factors influencing breast ptosis following reduction mammoplasty

Ptosis is a common complication after reduction mammoplasty, but its main influencing factors remain unclear. We aimed to evaluate the roles of age, smoking, pregnancies, hypertension, diabetes, preoperative glandular composition, stretch marks, Fitzpatrick skin type, weight change, Ribeiro flap usage, resected tissue weight, and preoperative and postoperative breast volume on breast droop within the first year after surgery.

Overall, 127 women who consecutively underwent reduction mammoplasty within 3 years took part in this study. Previously cited recorded data were noted and exported in Prism10 for correlation analysis with two indexes of breast ptosis: sternal notch-nipple and nipple-inframammary fold T12-T1 deltas.

For breast ptosis, the major influencing positive factors were age, postsurgery breast volume, stretch mark score, estimated preoperative major glandular composition of the breast, and delta weight. Smoking history and diabetes mellitus correlate in a moderate manner. Pregnancy weakly positively correlated with breast ptosis, whereas preoperative breast volume, resected breast weight, and Fitzpatrick skin type did not correlate with the investigated indexes. The only factor that negatively correlated with breast ptosis indexes was the usage of Ribeiro flap.

Breast ptosis after reduction mammoplasty is strongly correlated with age, postsurgery breast volume, stretch mark score, estimated preoperative major glandular composition of the breast, and delta weight in the first year after surgery. Other influencing factors were smoking history, diabetes mellitus, and history of pregnancy. The Ribeiro flap proved to have a protective role.