“It’s just like a normal external bra!”Snoopy-nosed Redundant Skin Envelopes

From Israel21c via Women’s Health News comes this new surgical procedure designed to help women fork out piles of cash and a world of pain for patriarchally-approved body shape: Minimally Invasive Mastopexy. Because we all have a disease, you see, called ptosis of the breasts. “Ptosis!” It sounds horrible, doesn’t it? Kinda like a cross between a sneeze and a phlegm-spit. You wouldn’t want to have ptosis in public. But now, the solution is here! And it’s “minimally invasive”, which sounds just super.

So, Adi Cohen and his merry followers plan to slice women’s chests open and insert silicone breast harnesses, suspending them from their ribs and connective tissue. “It’s like a normal external bra!”, they enthuse. Except, y’know, with blood and pain and complications and stuff.

Who are the first in line in the process of fatigue-testing and tissue-testing of these revolutionary ptosis-treatment devices? Pigs. Apparently there are a pile of sows in Israel walking around feeling empowered because they now have perky teats, despite having birthed and raised a passel o’ piglets.

And Cohen himself? Oh, he loves women. Look, some of his best friends are women!

He recalls discussing the MIM technique over Friday night dinner with friends.

“All the women said, ‘I want to be the first one!’ It was like a fire in the fields! Everyone was very enthusiastic about the idea,” he said. “The aesthetic market is growing rapidly; most women are willing to try things out – it’s becoming like a trend.”

Whereas in the past only older women wanted to reshape their bodies, today teen girls are open to augmentation treatments and breast-lifts added Cohen. “We’re not encouraging this trend, we are simply trying to minimize risk.”

He goes on:

“Our device is safer than breast surgery”

Pants on fire.

Edited to add: I can’t sleep, so I thought I’d add a few more bits and pieces to this post.

Here’s a study
called “Mastopexy revisited: A review of 150 consecutive cases for complication and revision rates.” You need a subscription to read the whole thing, so I thought I’d just pick out one choice paragraph. Emphasis is mine.

“Ptosis” is derived from the Greek word “fall,” and is defined as the “abnormal lowering or prolapse of an organ or body part.” Ptosis of the breast is an increasingly frequent concern for many patients, because the media portrays women of all ages as having youthfully shaped breasts. While a significant number of women never have an elevated nipple-areolar complex, the effects of time and childrearing eventually result in descended breasts in most women. The degrees of ptosis have previously been categorized by Regnault.

And from emedicine:

While the prevalence of breast ptosis is difficult to estimate, the frequency of mastopexy clearly is increasing. In 1992, the American Society of Plastic Surgeons reported that fewer than 8000 mastopexies were performed. The 2004 report indicates that more than 98,000 mastopexies were performed in the United States alone.


Etiology is varied and can be due to several components but gravity seems to be a common factor. Younger patients are more prone to ptosis because of excessive breast size or thin skin, thus the intertwining of breast reduction and mastopexy procedures. Ptosis in middle-aged patients usually is due to postpartum changes; the breast skin is stretched during lactation or engorgement, and afterward the breast gland atrophies, leaving loosened skin. Finally, in postmenopausal patients, further atrophy, gravity, loss of skin elasticity due to age, and weight gain are factors in creating breast ptosis.


With time, relaxation of Cooper ligaments and dermal laxity cause descent of the breast tissue and NAC. Postpartum involutional changes exacerbate the laxity of the suspensory ligaments and skin envelope. To properly correct these changes, elevating the breast parenchyma is necessary. In addition, the redundant skin envelope must be removed and the NAC must be transposed.


A classification system has been suggested by Regnault and modified by numerous authors. The most commonly used system is as follows:

* Grade 1: Mild ptosis – Nipple just below inframammary fold but still above lower pole of breast
* Grade 2: Moderate ptosis – Nipple further below inframammary fold but still with some lower pole tissue below nipple
* Grade 3: Severe ptosis – Nipple well below inframammary fold and no lower pole tissue below nipple; “Snoopy nose” appearance
* Pseudoptosis – Inferior pole ptosis with nipple at or above inframammary fold; usually observed in postpartum breast atrophy

Uh, dudes? The prevalence isn’t “difficult to estimate”, it’s 100%. Every Earthbound human breast will change shape and travel south. As you later identify, the common factor is gravity. So what’s with the “abnormal” designation, the “pathophysiology” heading, and the clinical “grading” system?

Is “Snoopy-nosed Redundant Skin Envelopes” too long for a band name?

More discussion at Feministe.

Categories: gender & feminism, health

Tags: ,

34 replies

  1. http://feministe.powweb.com/blog/archives/2007/08/13/thinking-outside-the-bra/
    What does it say that a blog called “Feministe” just doesn’t get it?

  2. Holy crap.

    Have just posted there.

  3. I was chatting to tigtog when I was down in Sydney recently about a friend of mine who’d given up on some of the US feminist blogs on the grounds that they were sometimes anything but. I can kinda see why now.

  4. Feministe is usually pretty good in my experience, though I certainly don’t agree with everything posted there. (But then, I don’t agree with everything posted on any blog).
    I suspect the disconnect is coming from a combination of two things:
    – woefully inadequate cynicism, and misplaced trust in medical “research” and patriarchal medicine’s interference with women’s bodies
    – deep dissatisfaction with current mainstream breast management, including bras.

  5. I can understand the latter – but the absence of cynicism is a worry. Maybe there’s a bit of a cultural disconnect with our US friends at work?

  6. You need only look at USAn feminist discussions of birthing (including their almost complete absence) to reveal the peculiar holes in the cynicism of many.
    I’m not sure what the solution is, or whether there is one, but I’ll just keep plugging away at my bits and pieces of blog-consciousness-raising.

  7. Well I used to think (and say) that the world might be a marginally better place if there were 300 million Australians and 20 million Americans rather than the other way around, but ten years and more of John Howard has caused some rethinking.
    I think it’s precisely blind spots which are crying out to us to be filled in that reveal the finer texture of cultural difference. And the cultural difference between Australia and America is very real – even if we think we’re on the same political ground.

  8. … and we very much have our own cultural blindspots; they’re just harder to see. Australia and Australians don’t exactly have a whole lot of high ground to cling to here.
    [eta: Perhaps that was unnecessarily pessimistic. The last few weeks have taken it out of me a bit.]

  9. Oh, but I completely agree. that was the point of my comment about rethinking.

  10. It’s safer than breast surgery because it is breast surgery!
    Wait. No.

  11. I love the way that it looks like it self-selects women who have almost-but-not-quite-patriarchally-perfect perky breasts, just “suffering” a little from the effects of gravity or motherhood, or both. As problematic as the normalising effect of a bra is in eliding natural variations in bust shape, at least the concept of a bra is customisable to offer necessary support to women with large and/or pendulous breasts. I can’t imagine this idea would ever work for someone of my bust size and shape without a radical breast reduction first. Only naturally gender-conforming women need apply, for a little fine-tuning of their anxieties as well as their chests.

  12. Ah, Brooklynite beat me to it!
    ”Our device is safer than breast surgery”
    Q: in what way is this not breast surgery?????

  13. Mark, I kind of hear you, but Feministe is pretty good overall. Agreed that it’s about cultural blindspots, and to a degree USA feminists having to confront a more polarised political field than us.
    But across USA and AU I’d say the major cultural blindspots within feminism remain domestic – between women who have the cultural and economic capital to be represented in feminism and broader politics or not.

  14. re: the “is it not breast surgery” Any health policy geeks here?
    Because the topic of blurring the line between cosmetic surgery came up at a public health seminar I went to last year, where the wonks were livid that increasing cosmetic surgery demand impacts upon funding & staffing for medically necessary procedures.
    Partially this was implied as resulting from outright fraud of Medicare, but there were aspects about investment in education and infrastructure that I didn’t get. Anyone?

  15. What does it say that a blog called “Feministe” just doesn’t get it?
    It says “guest-blogger.” Sara’s not a Feministe regular.
    I’m no longer a regular there, either, but I’m rather horrified at this thing. First, how can you test this accurately on an animal that doesn’t walk upright?
    But more importantly, this hardly looks “minimally invasive.” So, unnecessary, invasive surgery with little study of long-term effects or what happens when the person getting this little boost does something active (hardly a foreign concept to Israelis, since women all have to serve in the military). But it’s just like an external bra!

  16. I’m guessing they’re going for the “not breast surgery” weaselclaimer because the implant placement doesn’t involve chopping into or removing glandular tissue (though it may well disrupt milk ducts, and of course involves all sorts of other rather invasive stuff like suspending wires from your first rib, and a whole lot of fiddle-faddling about under the skin.
    What sort of wonks were getting hot under the collar about what sorts of procedures in what sort of funding model? I know there’s been a fair kerfuffle this week over the restriction on publicly-funded neonatal male circumcision in Victorian hospitals to medically necessary circumcision only; no longer can new parents get their freebie neonatal cosmetic foreskin amputation thrown in as a birth perk.
    The resulting outcry focussed on how UNFAIR it was that circumcision was being BANNED and about how now they would all just GO and get their own circs done with FILTHY RUSTY KNIVES and it would be YOUUUUUUR FAULT.
    Of course, without neonatal circumcision, Bubba might have a few more weeks of trauma noticing that his microwinkie has a hoodie while Daddy’s has a visible glans (and a shock of hair, and veins, and is fifteen times the size, along with the rest of him). But those few weeks between birth and being able to organise a private-sector circumcision may just be enough to scar him psychosexually and give him Daddy issues for life.

  17. I wrote the post at Feministe, and I should point out that I’m a guest poster. And I do realize that this thing might not work out well, and I’m not signing up to go under the knife any time soon. But as someone who feels sort of chained to bras, I might like to have the boob-holding-up benefits built into my body if it were possible.

  18. “Snoopy-nosed.” Heh. Thanks for the link, and for pointing out the oddity of calling something “abnormal” while acknowledging the ubiquitous nature of gravity and aging.

  19. As some regular readers know, I had a breast reduction mammoplasty in 2003, due to constant and increasing intrascapular pain. It was a great success, however:
    I couldn’t do vigorous exercise for a full two years after that operation. Obviously I expected the convalescent period afterwards to last for several months, but I had to be gentle for much longer than that, and I still occasionally get surprised. I can do yoga, I can swim, I can powerwalk, I can work hard in the garden – but I still wouldn’t be keen on jogging or raquet sports (and I used to love squash).
    The problem for me is the skin scar tissue and the scarring immediately beneath the skin: unexpected vigorous movement can still pull and sting. The idea of having not only that scarring, but something sitting internally that is attached and pulling on the ribs and fascia as well?
    It would have to be worse than what I have to work around. It would have to be limiting.

  20. I wrote about this thisaway, and bless you for picking up on the use of the word ‘ptosis’.  I couldn’t even think on the whole tested-on-pigs part; that’ll have to wait until I can poke at this some more.

  21. How exactly are you supposed to feel a lump forming under that thing? I don’t know how plastic surgeries of this type circumvent the “first do no harm” oath. Isn’t unneeded surgery doing some harm?
    Tigtog, I have a friend who went through the same procedure as you and I wouldn’t put it in the same league at all. She had terrible back pain all of her life; that surgery provided long-term relief.
    I’m sorry you’ve experienced negative effects. Her only complaint is that she can’t really feel much of anything as they cut the nerves to her areolas.

  22. Waagh! They’re pathologising age! (In women only, obv.)
    And feministe is shocking. I just went and commented there.

  23. Gayle, my only minor negative effect is due to having the sort of skin that forms lumpy scars – as do many other people. It is minor – it’s not that I feel pulls and stings every day, but it definitely does discourage me from fully vigorous exercise. The relief from pain more than compensates for this minor drawback, and I can do more vigorous exercise since the operation than I could do before it.
    I paid more to have my surgeon preserve the nerve pedicle to my areolas rather than simply severing the tissue. Mostly successful in preserving sensation, although I already had sensory loss simply due to the weight dragging on my nerve tissue for years before the reduction. Not everybody can afford that extra procedure and not every surgeon offers it.
    The surgeons offering cosmetic breast “enhancement” procedures rarely frankly disclose the risks to sensation (and breastfeeding potential) due to their work – it’s mentioned just as much as legally required and handwaved away.

  24. Breast droopage is now a medical abnormality that requires surgery?


  25. I can work hard in the garden.

    This has yet to be tested empirically.
    (Apologies for flippancy).

  26. Presumably the new cure for penises not being fully erect and ready to pleasure hetero women at a moments notice will involve some sort of scaffolding.

  27. I can assure the readership that Mr Tog is not the one who pulls the weeds and prunes the bouganvillea. He does however have other talents.

  28. The pathophysiology you talk about “relaxation of the Cooper’s ligaments” is not so much relaxation is time/gravity induced breakage of elastin fibres and thoroughly normal as you correctly state.
    Back when I was studying, the “ptosis” was not discussed, the result of stretching of “The suspensory ligaments of Sir Astley Cooper” was known as “Cooper’s Droop” (nothing to do with “Foster’s flop”). Maybe “Cooper’s Droop” sounds too Anglo-Saxon to be medicalized – it needs a good latin/greek name for that.
    Aah, the wonders of medicalizing normality: so good for the wallets of industry!
    But, and here’s the twist: you can use this bit of medicalizing: if health funds are prepared to cough up for surgery, they should be very happy to cough up for prophylactic devices that prevent the larger expense, and thus women should be able to claim on the significant costs of decent bras.

  29. Ah, but that way lies madness. There are orders of magnitude more evidence for a three-squares-plus-snacks diet together with a feminist awakening reducing the “need” for breast augmentation, than there is for bra-wearing reducing the progression of “ptosis”. But I don’t see health funds offering to pay a weekly grocery bill and registration fees for womyn’s conference attendances for body-dysmorphic skinny women.
    Before anyone decides to rebut the evidence I’m asserting here, consider the size of the body of valid, peer-reviewed scientific evidence for ptosis prevention by the use of brassieres.

  30. I am reminded of Bette Midler’s routine about Otto Titsling, the inventer of the over-the-shoulder-boulder-holder.
    As for the pathologizing of women’s bodies: remember a few years ago, when “micromastia” was invented?

  31. Zuzu, I bring you: “Outer Thigh Saddle Bag Deformity”. Apparently these are “An unsightly break in your body’s natural contour”.
    Probably best not to get me started on labiaplasty.


  1. Titsling! at Kindly Póg Mo Thóin
  2. Faves: Bodies, Breasts ‘n’ Birth edition — Hoyden About Town
  3. Latisse hits the market. — Hoyden About Town
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