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Background <p>Implant-only augmentation is generally considered to have limited effect in correcting breast ptosis, and standardized selection criteria are lacking. Traditional grading focuses mainly on nipple–inframammary fold (IMF) position, overlooking the inferior breast border (IBB)’s relation to the IMF. This study proposes and validates a two-dimensional quantitative assessment method—Nipple Ptosis Score (NPS) and Inferior Breast Border Ptosis Score (IBPS)—to evaluate ptosis and predict satisfaction after transaxillary implant-only augmentation.</p> Methods <p>We retrospectively analyzed patients undergoing transaxillary implant-only augmentation between June 2023 and June 2024. Preoperative and 12-month postoperative NPS and IBPS were measured. Patient satisfaction at 12 months was recorded. Correlation analysis, receiver operating characteristic (ROC) curves, and one-way ANOVA were used to assess validity, predictive accuracy, and associations with satisfaction.</p> Results <p>Twenty-five patients (50 breasts) were included. The method demonstrated good construct and external validity. ROC-derived cutoff scores were IBPS ≤ 1.5 (area under the curve [AUC] = 0.839) and NPS ≤ 2.5 (AUC = 0.710). ANOVA indicated that breasts meeting both thresholds achieved the highest postoperative satisfaction, whereas those meeting neither had the lowest (<i>p</i> &lt; 0.001). Meeting only the IBPS threshold showed a trend toward higher satisfaction than meeting only the NPS threshold (<i>p</i> = 0.050).</p> Conclusions <p>The two-dimensional quantitative assessment method provides an objective evaluation of breast ptosis. In Chinese women meeting implant volume requirements, preoperative IBPS ≤ 1.5 and NPS ≤ 2.5 predict higher satisfaction after transaxillary implant-only augmentation. IBPS shows stronger predictive potential for patient selection and surgical planning.</p> Level of Evidence I <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>

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A Two-Dimensional Quantitative Assessment Method for Breast Ptosis Following Transaxillary Implant Augmentation

  • 期刊论文

  • 发表日期：

    2025年12月5日

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  • Hongyu Liang,
  • Xuefeng Zhang,
  • Yue Liu,
  • Boyang Xu,
  • Wenyue Liu,
  • Shangshan Li,
  • Jie Luan

摘要

Background

Implant-only augmentation is generally considered to have limited effect in correcting breast ptosis, and standardized selection criteria are lacking. Traditional grading focuses mainly on nipple–inframammary fold (IMF) position, overlooking the inferior breast border (IBB)’s relation to the IMF. This study proposes and validates a two-dimensional quantitative assessment method—Nipple Ptosis Score (NPS) and Inferior Breast Border Ptosis Score (IBPS)—to evaluate ptosis and predict satisfaction after transaxillary implant-only augmentation.

Methods

We retrospectively analyzed patients undergoing transaxillary implant-only augmentation between June 2023 and June 2024. Preoperative and 12-month postoperative NPS and IBPS were measured. Patient satisfaction at 12 months was recorded. Correlation analysis, receiver operating characteristic (ROC) curves, and one-way ANOVA were used to assess validity, predictive accuracy, and associations with satisfaction.

Results

Twenty-five patients (50 breasts) were included. The method demonstrated good construct and external validity. ROC-derived cutoff scores were IBPS ≤ 1.5 (area under the curve [AUC] = 0.839) and NPS ≤ 2.5 (AUC = 0.710). ANOVA indicated that breasts meeting both thresholds achieved the highest postoperative satisfaction, whereas those meeting neither had the lowest (p < 0.001). Meeting only the IBPS threshold showed a trend toward higher satisfaction than meeting only the NPS threshold (p = 0.050).

Conclusions

The two-dimensional quantitative assessment method provides an objective evaluation of breast ptosis. In Chinese women meeting implant volume requirements, preoperative IBPS ≤ 1.5 and NPS ≤ 2.5 predict higher satisfaction after transaxillary implant-only augmentation. IBPS shows stronger predictive potential for patient selection and surgical planning.

Level of Evidence I

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.