Cooper's ligaments

Last updated
Cooper's ligaments
Grant 1962 12.png
Dissection of human breast: Cooper's ligaments labeled as "Retinacula cutis (Ligs. of Cooper)" and "Retinacula cutis"
Details
Identifiers
Latin retinaculum cutis mammae,
ligamenta suspensoria mammaria
TA98 A16.0.02.015
TA2 7109
FMA 71433
Anatomical terminology

Cooper's ligaments (also known as the suspensory ligaments of Cooper and the fibrocollagenous septa) are connective tissue in the breast that help maintain structural integrity. They are named for Astley Cooper, who first described them in 1840. [1] [2] Their anatomy can be revealed using Transmission diffraction tomography. [3]

Contents

Cooper's suspensory ligament should not be confused with the pectineal ligament (sometimes called the inguinal ligament of Cooper) which shares the same eponym. Also, the intermediate fibers and/or the transverse part of the ulnar collateral ligament are sometimes called Cooper's ligament(s). [4] [5]

Structure

The ligaments run from the clavicle and the clavipectoral fascia, branching out through and around breast tissue to the dermis of the skin overlying the breast. The intact ligament suspends the breast from the clavicle and the underlying deep fascia of the upper chest. This has the effect of supporting the breast in its normal position, and maintaining its normal shape. Without the internal support of this ligament, the breast tissue (which is heavier than the surrounding fat) sags under its own weight, losing its normal shape and contour.[ citation needed ]

Clinical significance

The suspensory ligaments of Cooper play an important role in the change in appearance of the breast that often accompanies the development of inflammatory carcinoma of the breast in which blockage of the local lymphatic ducts causes swelling of the breast. Because the skin remains tethered by the suspensory ligaments of Cooper, it takes on a dimpled appearance reminiscent of the peel of an orange (peau d'orange). Carcinomas can also decrease the length of Cooper's ligaments leading to a dimpling.

Relationship to sagging

Many women believe that sagging (ptosis) is caused by the failure of the Cooper's ligaments to support the breast tissue. In fact, ptosis is partly determined by genetic factors, but a review found that the biggest factors are higher body mass index, larger breast size, significant weight loss, smoking, her number of pregnancies, and her age. [6]

Many women incorrectly believe that wearing a brassiere prevents their breasts from sagging later in life and that breasts cannot anatomically support themselves. [7] But bra manufacturers have stated that because breasts are formed of fatty tissue and not muscle, bras only affect the shape of breasts while they are being worn. [8] [7]

Pathologically heavy breasts may cause pain in the woman's upper thoracic area, but this may be due to a poorly-fitting bra. Numerous reports state that 80–85% of women are wearing the wrong bra size. [9] [10] [11] [12] [13]

In middle-aged women, breast ptosis is caused by a combination of factors. If the woman has had children, postpartum hormonal changes will cause the depleted milk glands to atrophy. Women who experience multiple pregnancies repeatedly stretch the skin envelope during engorgement while lactating. As a woman's breasts grow in size during repeated pregnancies, the Cooper's ligaments that maintain the position of the mammary glands against the chest are stretched and gradually lose strength. Breast tissue and suspensory ligaments may also be stretched if the woman is overweight or loses and gains weight.

Related Research Articles

<span class="mw-page-title-main">Breast</span> Region of the torso of a primate that in females serves as a mammary gland

The breast is one of two prominences located on the upper ventral region of a primate's torso. Both females and males develop breasts from the same embryological tissues.

<span class="mw-page-title-main">Nipple</span> Part of the breast

The nipple is a raised region of tissue on the surface of the breast from which, in females, milk leaves the breast through the lactiferous ducts to breastfeed an infant. The milk can flow through the nipple passively or it can be ejected by smooth muscle contractions that occur along with the ductal system. Male mammals also have nipples but without the same level of function, and often surrounded by body hair.

<span class="mw-page-title-main">Pubic symphysis</span> Cartilaginous joint between the front of the left and right hip bones

The pubic symphysis is a secondary cartilaginous joint between the left and right superior rami of the pubis of the hip bones. It is in front of and below the urinary bladder. In males, the suspensory ligament of the penis attaches to the pubic symphysis. In females, the pubic symphysis is close to the clitoris. In most adults it can be moved roughly 2 mm and with 1 degree rotation. This increases for women at the time of childbirth.

<span class="mw-page-title-main">Fascia</span> Layer of connective tissue in the body

A fascia is a generic term for macroscopic membranous bodily structures. Fasciae are classified as superficial, visceral or deep, and further designated according to their anatomical location.

<span class="mw-page-title-main">Breast reduction</span> Plastic surgery procedure

Reduction mammoplasty is the plastic surgery procedure for reducing the size of large breasts. In a breast reduction surgery for re-establishing a functional bust that is proportionate to the patient's body, the critical corrective consideration is the tissue viability of the nipple–areola complex (NAC), to ensure the functional sensitivity and lactational capability of the breasts. The indications for breast reduction surgery are three-fold – physical, aesthetic, and psychological – the restoration of the bust, of the patient's self-image, and of the patient's mental health.

<span class="mw-page-title-main">Axilla</span> Area of the human body beneath the joint between arm and torso

The axilla is the area on the human body directly under the shoulder joint. It includes the axillary space, an anatomical space within the shoulder girdle between the arm and the thoracic cage, bounded superiorly by the imaginary plane between the superior borders of the first rib, clavicle and scapula, medially by the serratus anterior muscle and thoracolumbar fascia, anteriorly by the pectoral muscles and posteriorly by the subscapularis, teres major and latissimus dorsi muscle.

<span class="mw-page-title-main">Sacroiliac joint</span> Joint of the pelvis and spine

The sacroiliac joint or SI joint (SIJ) is the joint between the sacrum and the ilium bones of the pelvis, which are connected by strong ligaments. In humans, the sacrum supports the spine and is supported in turn by an ilium on each side. The joint is strong, supporting the entire weight of the upper body. It is a synovial plane joint with irregular elevations and depressions that produce interlocking of the two bones. The human body has two sacroiliac joints, one on the left and one on the right, that often match each other but are highly variable from person to person.

<span class="mw-page-title-main">Nursing bra</span> Specialized brassiere

A nursing bra is a specialized brassiere that provides additional support to women who are lactating and permits comfortable breastfeeding without the need to remove the bra. This is accomplished by specially designed bra cups that include flaps which can be opened with one hand to expose the nipple. The flap is usually held closed with a simple clasp or hook.

<span class="mw-page-title-main">Astley Cooper</span> British surgeon and anatomist (1768–1841)

Sir Astley Paston Cooper, 1st Baronet was a British surgeon and anatomist, who made contributions to otology, vascular surgery, the anatomy and pathology of the mammary glands and testicles, and the pathology and surgery of hernia.

<span class="mw-page-title-main">Inverted nipple</span> Medical condition

An inverted nipple is a condition where the nipple, instead of pointing outward, is retracted into the breast. In some cases, the nipple will be temporarily protruded if stimulated. Both women and men can have inverted nipples.

<span class="mw-page-title-main">Intermammary cleft</span> Breast cleavage

The intermammary cleft, intermammary sulcus, or sulcus intermammarius is a surface feature of males and females that marks the division of the two breasts with the sternum (breastbone) in the middle. The International Federation of Associations of Anatomists (IFAA) uses the terms "sulcus intermammarius" or "intermammary cleft" when referring to the area between the breasts.

<span class="mw-page-title-main">Breast hypertrophy</span> Human disease

Breast hypertrophy is a rare medical condition of the breast connective tissues in which the breasts become excessively large. The condition is often divided based on the severity into two types, macromastia and gigantomastia. Hypertrophy of the breast tissues may be caused by increased histologic sensitivity to certain hormones such as female sex hormones, prolactin, and growth factors. Breast hypertrophy is a benign progressive enlargement, which can occur in both breasts (bilateral) or only in one breast (unilateral). It was first scientifically described in 1648.

Mastopexy is the plastic surgery mammoplasty procedure for raising sagging breasts upon the chest of the woman, by changing and modifying the size, contour, and elevation of the breasts. In a breast-lift surgery to re-establish an aesthetically proportionate bust for the woman, the critical corrective consideration is the tissue viability of the nipple-areola complex (NAC), to ensure the functional sensitivity of the breasts for lactation and breast-feeding.

<span class="mw-page-title-main">Ptosis (breasts)</span> Sagging of the female breast

Ptosis or sagging of the female breast is a natural consequence of aging. The rate at which a woman's breasts drop and the degree of ptosis depends on many factors. The key factors influencing breast ptosis over a woman's lifetime are cigarette smoking, her number of pregnancies, higher body mass index, larger bra cup size, and significant weight change. Post-menopausal women or people with collagen deficiencies may experience increased ptosis due to a loss of skin elasticity. Many women and medical professionals mistakenly believe that breastfeeding increases sagging. It is also commonly believed that the breast itself offers insufficient support and that wearing a bra prevents sagging, which has not been found to be true.

<span class="mw-page-title-main">Breast prostheses</span>

Breast prostheses are breast forms intended to look like breasts. They are often used temporarily or permanently by women after mastectomy or lumpectomy procedures, but may also be used by for aesthetic purposes. There are a number of materials and designs; although, the most common construction is gel in a plastic film meant to feel similar to a person's skin. Prostheses may be purchased at a surgical supply store, pharmacy, custom lingerie shop, or even through private services that come to a person's home. There are many types of ready made breast prostheses including full or standard prostheses, partial prostheses such a shell prostheses, and stick on prostheses. Customized options are also available from specialty shops, which are moulded to fit an individual's chest by taking an impression of the breast(s). The areola and nipple may be replicated as part of the breast form or as separate nipple prosthesis. Both custom made and off-the shelf breast prostheses come in varieties that are designed to either be held in a pocket in a specially designed mastectomy bra or attached to the skin via adhesive or other methods and worn with a standard bra. There are many factors to consider when selecting breast prostheses such as different types and the care they require, insurance coverage, and psychosocial effects.

A bra, short for brassiere or brassière, is a form-fitting undergarment that is primarily used to support and cover a woman's breasts. A typical bra consists of a chest band that wraps around the torso, supporting two breast cups that are held in place by shoulder straps. A bra usually fastens in the back, using a hook and eye fastener, although bras are available in a large range of styles and sizes, including front-fastening and backless designs. Some bras are designed for specific functions, such as nursing bras to facilitate breastfeeding or sports bras to minimize discomfort during exercise.

<span class="mw-page-title-main">Outline of human anatomy</span> Overview of and topical guide to human anatomy

The following outline is provided as an overview of and topical guide to human anatomy:

<span class="mw-page-title-main">Maternal physiological changes in pregnancy</span>

Maternal physiological changes in pregnancy are the adaptations that take place during pregnancy that enable the accommodation of the developing embryo and fetus. These are normal physiological adaptations that cause changes in behavior, the functioning of the heart, blood vessels, and blood, metabolism including increases in blood sugar levels, kidney function, posture, and breathing. During pregnancy numerous hormones and proteins are secreted that also have a broad range of effects.

The pencil test is an informal test of breast development and the need to wear a bra. It was published in a 1971 advice column by Ann Landers mostly containing reader responses, pro and anti-bra, to her recent column "berating the braless female who shamelessly bounced and flopped and went shopping ... [which for Landers] created a deluge of mail". One Chicago correspondent chimed in:

The question "to bra or not to bra” can be easily answered if the undecided woman will apply this test to herself. Take an ordinary woodcase pencil. Put it under one breast. If the pencil stays there you should wear a bra. If it falls, you can go braless.

<span class="mw-page-title-main">Bralessness</span> Movement consisting of not wearing a bra

In Western society, since the 1960s, there has been a slow but steady trend towards bralessness among a number of women, especially millennials, who have expressed opposition to and are giving up wearing bras. In 2016, Allure magazine fashion director Rachael Wang wrote, "Going braless is as old as feminism, but it seems to be bubbling to the surface more recently as a direct response to Third Wave moments like #freethenipple hashtag campaign, increased trans-visibility like Caitlyn Jenner's Vanity Fair cover ... and Lena Dunham's show Girls."

References

  1. synd/3342 at Who Named It?
  2. Cooper, Astley (1840). On the anatomy of the breast. London : Longman, Orme, Green, Brown, and Longmans. pp. 49–50.
  3. Simonetti F, Huang L, Duric N, Littrup P (July 2009). "Diffraction and coherence in breast ultrasound tomography: a study with a toroidal array". Medical Physics. 36 (7): 2955–65. Bibcode:2009MedPh..36.2955S. doi:10.1118/1.3148533. OSTI   957784. PMID   19673194.
  4. "Transverse ligament of elbow".
  5. Waldeyer's Human Anatomy - Membrum superius, articulatio cubiti
  6. Rinker, Brian; Veneracion, Melissa; Walsh, Catherine P. (May 2010). "Breast Ptosis: Causes and Cure". Annals of Plastic Surgery. 64 (5): 579–584. doi:10.1097/SAP.0b013e3181c39377. ISSN   0148-7043. PMID   20354434. S2CID   8953778.
  7. 1 2 "Female Intelligence Agency: Why do women wear bras?". 007b Breast. Retrieved 10 May 2011.
  8. Cawthorne, Simon (November 2000). "Bras, the Bare Facts". Channel 4.
  9. Wood K, Cameron M, Fitzgerald K (2008). "Breast Size, Bra Fit and Thoracic Pain in Young Women: A Correlational Study". Chiropractic & Osteopathy. 16: 1. doi: 10.1186/1746-1340-16-1 . PMC   2275741 . PMID   18339205.
  10. "Right bra 'could halt breast ops' BBC". BBC News. 11 April 2008.
  11. "Are you wearing the right bra size?". Archived from the original on 2008-09-17.
  12. Lantin, Barbara (14 April 2003). "A Weight off my shoulders". The Daily Telegraph. London. Archived from the original on 14 January 2013. Retrieved 4 January 2011.
  13. "Rigby and Peller – Bra fitting". Archived from the original on 2013-01-04. Retrieved 2012-01-31.