How bad is the sag of my breasts? (Photo)

Question

Is this sag or just emptiness of the top? If it's sag, what grade would it be? Is it minimal, moderate or significant?

Donald Groves, MD · Answer

Hello and thank you for your question. Based on the pictures you've provided, you have a lack of upper pole fullness which is giving the appearance that the breasts are "drooping" or "sagging" more than they actually are. I would say you are right at the border between no ptosis (drooping) and grade 1 ptosis (mild drooping). If you'd like to address this, and desire more volume, you would benefit from a breast augmentation (implant placement) and depending on the position of your nipples after implant placement, possible also a small lift. I hope this helps!
Best,
Dr. Donald Groves
Plastic Surgeon

Semih Yildiz, MD, FEBOPRAS · Answer

The photos show upper pole emptiness, but they also suggest mild to moderate breast ptosis or pseudoptosis rather than just loss of fullness. A true grade depends on where the nipple sits compared with the inframammary fold on an exam; from the photos, the nipple position looks close to that fold and the lower breast has some descent, so I would not call it significant ptosis.

If your goal is only a little more upper fullness, an implant can help, but it will not reliably lift a low nipple or tighten a loose skin envelope. If you want the nipple higher and the breast shape tighter, a lift, with or without an implant depending on your desired size, may be the more predictable option. An in-person measurement is the best way to decide between implant alone, lift alone, or lift with implant.

Joel Patrick Maier, MD · Answer

You have mild ptosis of the breast. There is some breast tissue and nipple present below the fold of the breast, but it is minor in degree. Depending on what you desire,  a small saline implant with a vertical lift can address both the upper pole fullness and tighten up the breast. I hope this helps, thank you!

Chul Hwan Seul, MD, PhD · Answer

The concern isn't solely related to the upper breast shape; there's also a degree of sagging present. The evaluation of sagging typically involves assessing the alignment between the nipple position and the inframammary fold. While it's challenging to make a precise judgment based solely on photos, the sagging appears to fall within the range of what can be considered minimal to moderate.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants, if interested. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Thomas Trevisani, MD · Answer

Based on limited photos- it appears  that you have pseudo-ptosis which can be treated with mastopexy/lift+ possible smaller implants ( if you desire volume increase). You can also have just Augmentation with implants but it will not lift the breasts like lift would do-and the breasts will continue to sag overtime. I suggest that you seek an experienced Board Certified PS

Warren Schutte, MD · Answer

Thank you for the question and photos provided. It does appear that you have some tissue falling below the inframammary fold but your anatomy is still in good shape with nipple areolar complexes at nearly the maximally projecting point on the breast. If you are wanting more breast volume and added upper pole fullness, you could consider an implant alone to fill out your breast envelope and give you an appearance of a slightly higher, fuller breast.

Gary M. Horndeski, MD · Answer

It appears from your photographs, that you have grade I ptosis. The lift technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Newme1806,
based on your photos, it looks like you have moderate sagging so you will probably benefit from breast lift. My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. 
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

John Michael Thomassen, MD · Answer

When the nipple is at or just below the IMF it can be considered moderate.  A mastopexy can lift the breasts and reduce the areolas.  More volume with an implant can also be considered.

How bad is the sag of my breasts? (Photo)

Answers (17)

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