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The Relationship Between Breast Ptosis, Mastopexy Surgery, and Brassiere Cup Size
Katie Weichman1, Melissa Doft, MD2, Alan Matarasso, MD1.
1New York University, New York, NY, USA, 2Cornell University, New York, NY, USA.

BACKGROUND:
Women presenting for evaluation for mastopexy often express a desire to remain the same cup size or become smaller. While cup size remains a relatively ambiguous term and has extreme manufacturer variability, patient brand loyalty allows for accurate personal evaluation of changes in cup size. Surgeon observation suggested that mastopexy alone resulted in decrease cup size. The purpose of this investigation was to assess change in cup size in women undergoing mastopexy alone.
METHODS:
After obtaining IRB approval, a retrospective review of a single surgeon’s experience from February 2002 until May 2011 was completed. Patients included for evaluation underwent mastopexy alone, as defined by specimen weight <150 grams per side. Patients were excluded if they had prior breast augmentation, removal of implants at the time of mastopexy, combination breast augmentation-mastopexy, or incomplete follow-up. Once identified, patients were contacted by telephone to answer survey questions regarding pre and postoperative cup size, changes in bra manufacturer, hormone status, and weight gain/loss. Patients were then analyzed based on survey questions, degree of preoperative ptosis, surgical techniques, and complications.
RESULTS:
A total of sixty-one charts were reviewed and twenty patients (forty breasts), met inclusion criteria for this investigation. Patients had an average age of 46.3 years (range 35-76 years) and average body mass index (BMI) of 22.4 m/kg2 (range: 18.2-26.4 m/kg2). 80% (n=16) of patients had grade-two ptosis and 20% (n=4) had grade-three ptosis preoperatively. The average specimen weight per breast was 52.8 gm (range: 21-140 gm). Patients reported an average decrease in cup size of 0.8 cup sizes (range -2 to 3 cup sizes). Only one patient reported an increase in cup size and this patient started hormone replacement after mastopexy. Excluding this patient, an average decrease of 1.15 cup sizes(range: 0-3 cup sizes) was seen. No patients reported changing bra manufacturer.
CONCLUSIONS:
Mastopexy alone results in an average decrease in one-cup size postoperatively. This is important in for preoperative counseling of patients to help manage postoperative patient expectations. Possibly theories for diminished cup size include superiorly displaced volume resulting in diminished cup filling and diminished skin envelope.


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