Ask a doctor

I Have Breast Ptosis & Skin Problem Under my Breasts That Looks Like Hidradenitis Suppurativa, What Are my Options? (photo)

Breast ptosis is making me feel so low & so down about myself. I can't wear low cut tops,swim suits, bras don't fit and causes lumps under my armpits as I have to have the straps as tight as possible to prevent sagging while wearing clothes & I have had this problem since I was 13 & had it for 7 years. I've a reoccuring rash which causes holes which pus,close up & reopen again which is suspected Hidradenitis suppurativa. What are my options & what has caused ptosis, as I don't want a reduction?

Doctor Answers (10)

Hidraadenitis

+1

This does not lok like hidra adenitis suppurativa nor is it in the right location. These cysts need to be excised and this problem will go away


New York Plastic Surgeon
5.0 out of 5 stars 9 reviews

Hidradenitis Suppurativa, Breast Ptosis & Skin Problem

+1

What you have is problematic, but does not fit the diagnosis of hidradenitis, which involves area of apocrine sweat glands which are in proximity to hair follicles in the axilla, groin, and inner thigh. 

It may be that a breast lift will help here by eliminating the skin on skin contact. But before doing that it would be advisable to get the disease under control by excising all the abnormal tissue in the breast fold as a first stage, and later doing the more complicated lift is a clean surgical field. It looks like you have ample breast tissue to do a lift alone. If you are considering implants I would wait until the lift is healed, and that no recurrences are noted for at least six months due to the chances and consequences of implants infection.

Thank your for your question and for the posted photos. All the best. 

 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 30 reviews

HS and Breast Lift

+1

      If you have been diagnosed with HS and had medical treatment for the presumed HS without any results, it may be reasonable to excise this area in the inframammary foldAllow this to heal and determine if your disease recurs.  If it does not, then a full breast lift could be performed with or without an implant.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 191 reviews

You might also like...

Breast ptosis treated with Mini Ultimate Breast Lift

+1

The best option for breast ptosis is a new technique called The Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to lift your breast tissue higher on your chest wall to increase your upper pole fullness, displace your breast medial to increase your cleavage and reshape your breast.  This will alleviate the rash underneath your breasts and is done without vertical or boat anchor incisions.  Hidradenitis suppurativa can be treated with antibiotics and surgery if there are deep infections.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
5.0 out of 5 stars 123 reviews

Hidradenitis treatment then reduction?

+1

I think that you should be treated for your hidradenitis first and then when things have healed and are stable it is possible that you may be able to have a breast lift/reduction.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 16 reviews

Medical skin treatment followed by surgical breast rejuvenation

+1

Hello,

Thank you for the question and photos.  You should be able to get a very nice result with a breast lift with and breast augmentation.  The skin lesions you show can be caused by a number of different factors and should be evaluated by your primary care physician and/or a dermatologist.  I suspect it may not be hidradenitis but in any event healing of the wounds is ideal prior to surgical intervention.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 87 reviews

Breast Ptosis and Dermatitis?

+1

Thank you for the question and good quality pictures that demonstrate nicely your areas of concern.

It is clear that your breasts have caused you significant physical and probably psychosocial “distress”. I would suggest that you work on controlling the skin reactions first; consultation with well experienced dermatologists may be very helpful to you.

 Once the "dermatitis” has been treated  you may want to seek consultation with well experienced plastic surgeons to discuss options. Breast lifting may be at an operation that would be helpful to you at some point. As you know, the trade-off with breast lifting surgery is the presence of scars,  which may be a “deal breaker” for some patients.

Many patients (If properly selected and who are doing the operations at the right time of their lives  psychosocially) accept the scars associated with breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry. This acceptance of the scars is the essential “trade-off” associated with many of the procedures we do in the field of plastic surgery.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 702 reviews

Hidradenitis and breast lift

+1

you are a risky patient, i am afraid to say, as hidradenitis  is a chronic inflammatory skin problem ,reluctant to antibiotics, which may compromise even the result of the breast lift that you need . no breast reduction, just skin removal to allow the tissue to lift with the gland and redrape.

problem is that the lower part of the breast skin is affected by the dermatitis, which must be resolved before you do uncertain surgery, too risky, at my advice, to perform surgery with a concomitant skin infection 

Alberto Di Giuseppe, MBBS
London Plastic Surgeon

Hidradenitis and breast lift

+1

Hidradenitis is more commonly found in the axillary or hair bearing region.  This appears to be a chronic dermatitis.  You should see a dermatologist again.  You may be refractory to many antibiotics.  When skin touches skin, these irritations can develop and be very persistent.  I would personally not perform a lift in an area with prurulence (pus) or ongoing infection so I think it is extremely important for you to address the derm issues first.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 8 reviews

I Have Breast Ptosis & Skin Problem Under my Breasts That Looks Like Hidradenitis Suppurativa, What Are my Options?

+1

You have infra mammary infective dermatitis. You can have a lift no reduction that will remove the hanging breast skin that is rubbing causing the issue. Seek IN PERSON evaluations from boarded PSs in your city. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 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.