Mondor's Syndrome

Bottoming Out
Breast Hang with an Enlargement
Breast Hang without a Breast Lift
Breast Lift Variations -- Part I
Breast Lift Variations -- Part 2
Collapse of the Upper Outer Breast
Combined Surgery: Aug and Lipo
Combined Surgery: Aug & Tummy Tuck
Confusion on the Internet
Constricted Breast Deformity, Mondors
Early, High, Tight Breast Implants
High Riding Implants
Mondor's Syndrome
Post-op Nipple Asymmetry
Scars after Breast Enlargement
Silicone Gel Breast Implants
Small Can Be Lovely
Synmastia

by Peter T. Pacik, MD, FACS

Mondor's syndrome is a relatively uncommon problem following augmentation mammaplasty, in which temporary cords develop extending from below the breast towards the abdomen. We see this in approximately 1 to 2 percent of patients. It is thought that the cords are due to an inflammation of the superficial veins below the breast (figure 1). The cause is unknown. The cords become more prominent when the breast is pulled upwards and can be one sided or both sided. They appear at about 3 to 6 weeks, last a few months, and then usually disappear. I have never had to do surgery for them.

Mondor's syndrome is named after Henri Mondor (1885-1962), a surgeon in Paris, France who first described the disease in 1939. The presenting complaint is usually progressive pain in the lateral chest wall. On physical examination, a superficial, tender fibrous cord fixed to the skin can be palpated. The condition is benign and self-limited. No treatment is needed, and antibiotics have not been shown to alter the course. Pain or tenderness usually persists from 1 to 6 weeks, and the cord may last from 1 to 7 months. Analgesics help with symptomatic relief. There appears to be no risk of embolization. It is important to make the diagnosis of Mondor's disease in order not to confuse the condition with systemic diseases or lymphatic spread from carcinoma, thus avoiding unnecessary biopsy.

This patient is 44 years old, 5"7”, 145 lbs, pre-op bra size 36A, has 3 children and breastfed for 9 months. She was unhappy both with the small size of her breast (out of proportion to her large frame) and the breast sag. Total loss of volume can be seen in the upper part of the breast. This together with a low-lying nipple gives an aged matronly appearance (figures 2, 3).

Figures 4 and 5 show the pre-op markings for crescent mastopexy (2 cm lift on her right breast and a 2.2 cm lift on her left breast) and asymmetrical lowering of the breast fold to better integrate the implant into the inner lower area of cleavage. The inner aspect of her left breast has a more vertical orientation, the right a more oblique orientation that maintains itself into the postop appearance.

Figures 6 and 7 show the typical high riding implants at 8 days. In addition, the lower part of the breast is hanging off the breast implants; butterflies (steri-strips) are present to help support the crescent mastopexy.

By 13 months, the breasts appear more natural (figures 8 and 9). It usually takes 2 weeks to 4 months for the implants to drop into the new breast fold. When this happens, there is better integration of the implants with the breast, so that there is only one unit of combined implant and breast. The scars have healed well. These are typical scars for crescent mastopexy.

In a patient like this, it is almost impossible to achieve tight perky breasts. The breasts are improved and the patient is happy.

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The Plastic Surgery Center of Manchester, New Hampshire specializes in cosmetic plastic surgery, including body lifts, breast enlargements, breast lifts, breast reductions, eyelid surgery, ear surgery, facelifts, liposuction, neck and chin surgery, nose surgery, surgery after massive weight loss, and tummy tucks. We also offer facial rejuvenation (chemical peels, dermabrasion, laser skin resurfacing, Obagi Blue Peels, Glycolic Peels, Microdermabrasion), injectables and facial fillers (Botox, Radiesse and Restylane) and advanced skin care to patients from all over New England (Maine, Vermont, New Hampshire, Massachusetts). While no responsible practitioner gives guarantees for the work they do on the human body, we can at least reassure you that you will receive the expertise and dedication of over 30 years in practice. Our patients become an important part of our family and we try to get to know each patient individually and customize their treatment to meet their desires.