What is breast ptosis and what causes saggy breasts?
Breast shape changes dramatically with weight loss or after pregnancy and breast feeding. With this shape change the breasts drop lower on the chest and the nipple complex drops as well. Breast ptosis refers to this drop in position. There are degrees of ptosis depending of the level of the drop in nipple position, these are graded from 0 to grade 3 ptosis, referring to nipple position in relation to the breast fold. There are special tissues that holds the breast in their natural position, with weight gain or breast engorgement with breast feeding these tissues are stretched. When the volume increase is reversed, these specialized tissues are stretched and can no longer maintain the youthful appearance of the breasts and ptosis or sagging occurs.
Sagging breasts, how to perk things up? How to correct breast ptosis?
Implants alone will make the breasts fuller and cause a small lift for those with minor ptosis, but will not correct moderate to severe ptosis. Breast lift or mastopexy is needed to correct more major ptosis. Mastopexy involves tightening the breast tissue with reshaping it and repositioning the nipple complex. The nipples are not removed from the breast, the entire breast and nipple complex are repositioned. The are different forms of breast lift or mastopexy depending on the amount of sagging and the surgeon’s training. Depending on the type of ptosis, Sacramento plastic surgeon Dr. Mabourakh will discuss the type breast lift that bests suites your needs. In general if the nipple areolar complex is above or at the breast fold, an implant alone should be sufficient to correct the ptosis. However if the ptosis has caused the nipple to drop below the breast fold, an implant alone may not be sufficient. Adding an implant will enhance the result by creating an upper pole fullness that is hard to correct with lift alone. The larger the implant, the more weight is added, which will reduce the longevity of the lift. Its best to use the smallest implant that will give you the desired result.There are 3 basic types of lifts to correct the sagging breast. Doughnut mastopexy, keyhole or full inverted “T incision.
What is donut mastopexy? (also known as circumareolar or doughnut mastopexy)
Circumareolar mastopexy places an incision around the nipple complex in an attempt to lift the breast into position. This type of breast lift works well for minor ptosis, but tends to flatten the breast and causes rippling around the areola. In time it can cause the areola to become very wide and revisions may be required, but it avoids the vertical and breast fold incisions in other techniques.
What is a keyhole breast lift? ( Also known as vertical mastopexy)
Vertical mastopexy adds a vertical incision to donut mastopexy allowing removal of more skin and better tightening and reshaping of the breasts. This technique creates a longer lasting and more desirable shape to the breasts and avoids the rippling problem of donut mastopexy.
What is a full inverted “T” breast lift? when to use a full mastopexy?
A full lift is used when there is severe breast sagging. This techniques allows for maximum removal of excess skin and creates the best shape possible. Full breast lift is usually used when there has been significant weight loss, as in gastric bypass or in grade three ptosis. Full breast lift adds the additional scar at the breast fold to the keyhole technique, allowing for more skin removal and better breast reshaping.
Check out our before and after breast lift photo gallery in Sacramento.
After your consultation with Dr. Mabourakh in our Sacramento area office, you will be able to choose which technique best fits your expectations. Dr. Mabourakh will inform you of your options, and pros and cons of each technique, and whether a breast implant is appropriate or not. Please contact our office for an appointment.
By Shahriar Mabourakh, MD