Patient’s age/pubertal maturity

Patient’s goals and expectations

History of prior breast surgeries

History of smoking/tobacco use

Plan for future childbirth

Anticipated changes in weight

Personal or family history of breast cancer

Evaluate size and shape of bilateral breasts

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  Note breast asymmetries

Examine for presence of ptosis or pseudoptosis (see Table 37.1)

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  Pseudoptosis: The nipple is at or above IMF with lower pole breast ptosis

Important preoperative measurements include IMF level, NAC to IMF distance, sternal notch to nipple distance, and breast and chest width

Characteristics of Tuberous Breast Deformity

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  Constricted skin envelope in vertical and horizontal dimensions

  
  
  
  
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    Constricted or narrowed breast diameter

    
    
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    Elevated IMF

    
    
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    Short NAC to IMF distance

    
    
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    Deficient skin envelope in inferior pole

  
  
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  Hypoplasia of breast parenchyma

  
  
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  Herniation or pseudoherniation of breast parenchyma into NAC

Grolleau’s classification of tuberous breast deformity

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  Type I: Lower medial quadrant deficiency

  
  
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  Type II: Lower medial and lateral quadrant (entire lower pole) breast deficiency

  
  
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  Type III: Deficiency of all quadrants

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  

  Table 37.1 Regnault classification of breast ptosis

  Grade	Findings
  I (Mild)	Nipple at IMF
  II (Moderate)	Nipple below IMF, above most dependent part of breast
  III (Severe)	Nipple at inferior-most aspect of breast
  Pseudoptosis	Nipple at or above IMF with lower pole breast ptosis
  Abbreviation: IMF, inframammary fold.