Correction of Moderate Breast Ptosis

I am a 48 years, 5'4" and 140 lbs. I had one child and breastfed. I want to improve the sagging and increase volume of of my breast but wish to avoid scarring if possible.

My nipples are slightly below the breast crease and my areola are rather large. I have opted for submuscular saline implants of approximately 350cc. I know that this will not correct my sagging, but I hope my lift would be crescent or donut, not lollipop. Should I get my lift done concurrently?

Doctor Answers (13)

You would benefit from a breast uplift procedure

+1

Thank you very much for your enquiry, I thank you for sending your photographs.

I agree that your areola is slightly large and the areola on the left side is slightly lower than on the right.

I think you would benefit from a breast uplift procedure and it maybe possible to perform a dough nut lift on the right but I think you would require a lower part incision on the left to go into the correct position.

Other surgeons may favor an areola incision around your areola but I think the amount of elevation of your nipple will be limited.

If you would like to see videos of me performing this procedure please visit our website or search for Clinics Aurora on youtube.

I do wish you the best of luck if you do decide to go ahead with treatment.

Best wishes yours sincerely,

Adrian Richards
Plastic and Cosmetic Surgeon
Surgical Director of Aurora Clinics


London Plastic Surgeon
5.0 out of 5 stars 33 reviews

Should you have a breast lift and implants together

+1

A breat lift and Implants together does increase the risk of of surgery - specifically losing the nipple and areola and the need for revision.  However, it is safe to do under the right circumstances. For you, i think that a donot lift would help but will not lift all the way.  A lollipop would be better and the scar on a lollipop lift usually heals well.

Bivik Rajnikant Shah, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 9 reviews

Breast augmentation and lifts

+1

The point at which a breast is too ptotic (saggy) to augment with an implant in my opinion and experience is when the nipple is lower than 2 cm below the level of the inframammary crease behind it. If the nipple is at or above this level then an augmentation with an implant can be done with a minimal inframammary crease scar and the breast will get a lift "effect" although not a true lift. 

Also if the nipple level is at or above the 2 cm below level then a mastopexy (lift) will not make much improvement and is probably not worth the scars and does not do what the patient is usually looking for. 

Combining augmentation and lifts is doing two different operations on the same breast at the same time and they tend to work against each other. The degree of complexity goes up, predictability of outcome goes down, and the need for revisions goes up. 

In general, a true lift needs a "lollipop" type incisional scar but some borderline situations can be handled with a periareolar incision alone and yours may be one of them. "Crescent" mastopexies are to be condemned as misconceived. I also disagree that the the size or weight of implants alone causes bottoming out. 

Assuming an exam confirms the nipple level isn't too low, I would recommend an augmentation alone with a low profile implant that fits the width of your breast and will fill in the upper pole. This should give the effect of a lift and an increase of about a cup size. If you still feel you need a lift later then consider a periareolar lift but not at the same time as the augmentation.

Both of these procedures can be done under local anesthesia with IV sedation in an office setting that is properly experienced and accredited. 

Scott L. Replogle, MD
Denver Plastic Surgeon
4.0 out of 5 stars 1 review

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Correction of Breast Ptosis

+1

Without a physical exam, it is impossible to make accurate recommendations.  In cases of mild ptosis, I breast augmentation (dual plane technique) often can correct/improve very mild ptosis.  If additional lifting is needed, a crescenteric or periareolar mastopexy should to the trick.  Hope this helps.

C. Bob Basu, MD, FACS
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Periareolar breast lif, breast augmentation, breast ptosis

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You can have saline implants with periareolar lift. No problem. We do this type of surgery in our office on outpatient basis.  Hope it helps. HC

Helen S. Colen, MD
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Augmentation and Mastpexy Together

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Correction of Moderate Breast Ptosis
I am a 48 years, 5'4" and 140 lbs. I had one child and breastfed. I want to improve the sagging and increase volume of of my breast but wish to avoid scarring if possible.

My nipples are slightly below the breast crease and my areola are rather large. I have opted for submuscular saline implants of approximately 350cc. I know that this will not correct my sagging, but I hope my lift would be crescent or donut, not lollipop. Should I get my lift done concurrently?

Difficult to say without an exam, but going strictly of the photos you have posted, a circumareolar or donut lift is not the procedure for you.  You atleast need a vertical if not a full lift, no matter how big an implant you choose.  Implants do not LIFT the areola, a mastopexy is what lifts the areola.  Implants add volume and would infact makes things look worse in my opinion if you were to just get implants without a lift.  A lift and augmentation can be done at the same time.  I have in some patients added an implant to restore upper pole volume and done a breast reduction at the same time to not make the breast that much bigger, but essentially rearranging the volume.

What I would say is you are interested in improving the look of your breast.  If by putting implants in and doing a donut lift does not improve the look of the breast, then why bother.  You need to be examined and I would recommend seeing a few board certified plastic surgeons that feel comfortable and have done breast augmentation and mastopexy at the same time.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 46 reviews

Augmentation and lift

+1

A fulle xam is needed but perhaps you can have a lift around the areola only with the implants placed.  Hard to say withour an exam.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Moderate breast ptosis

+1

If you have already chosen a surgeon, he is the one to decide on how the procedures should be done. In general, it is quite safe to do an augmentation and periareolar or superior crescent lift together as long as you don't go too large. Be aware that a periareolar lift will usually enlarge the size of your areola.

RObin T.W. Yuan, M.D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 8 reviews

Correction of breast ptosis

+1

If you showed these pics to 10 different plastic surgeons you might get 10 different opinions. My experience is that to correct ptosis and to reshape your breast 3 dimensionally you need to have a 3DMENSIONAL proceedure like a mastopexy ( lift/shaping).

Be very careful about 350 cc prostheses in your breasts because the weight may cause recurrent ptosis or "bottoming out".

Barry H. Dolich, MD
Bronx Plastic Surgeon
5.0 out of 5 stars 1 review

Moderate or mild breast ptosis

+1

Remember that the point referred to when looking at breast droop is the 'center' of the nipple and not the lower edge of the areola. The crescent breast lift has a very poor record of success and would not get our vote. The around the nipple or 'round block' lift does make sense for mild to moderate ptosis. If you are concerned about the scar, consider a periareolar approach to the augmentation, and lift later on if the implant doesn't push the nipple high enough to please.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 31 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.