Grade 1.
When the nipple is at the level of hypomastias aspect.
Grade 2
When the nipple is below the hypomastias aspect..
Grade 3
When the nipple points towards the ground.
A particular decline is the fall of the gland without moving the position of the nipple and called pseudoptosis
At each grade we use different procedure in order to mobilize the nipple so as this gives a new natural , trying to make the less possible scaring.
In grade 1 the incision is only around the nipple .
In step 2 the incision extends vertically, and in step 3 the incision will oblique laterally direction.