Breast Ptosis (Sagging)

There is a difference between true ptosis, where the nipple is below the fold and the breast sags down and droops, and a completely low breast where the entire breast is low on the chest wall.

If there is true ptosis, with the nipple below the fold, the nipple has to be raised up and skin removed to tighten the skin-bra. This repositions and reshapes the breast.

There are basically two types of operation to tighten and reshape the breast.

The one with the least amount of scar is where the incision is just around the nipple, and a doughnut-shaped ring of skin is removed around the nipple, and a purse-string type of stitch is used to tighten and pull the skin in and close the wound. While this surgery has only the one scar around the areola, this scar tends to be wrinkled with the skin gathered or pleated around it, and may spread and become wider with time.

The other method is to move the nipple up and remove some skin from the lower part of the breast. This gives a scar around the nipple and in the shape of an inverted “T” under it. This method does give a more cone-shaped breast, with a smaller, tighter skin-bra.

Both these “mastopexy” operations also can be combined with the placement of a silicone breast prosthesis under the breast tissue to increase the size of the breast as well. The main risk with either of the operations is the scar involved and the later spreading of the scar, and the breast not holding its same shape as it gets pulled down with gravity. All breasts will begin to sag again, and the bigger the breast the greater the sag.

I do believe, however, that the peri-areolar type of lift, by allowing the whole of the lower breast tissue to be moved up and stitched to the chest wall up higher, gives the best result, for the least amount of scaring, and for the longest lasting lift.

These operations are done in the hospital with you asleep. You will need someone to drive you, and you go home the same day. Recovery takes about two weeks, with just a simple dressing inside your bra. It will take about one month for full healing.