32DD/34D bra, how would you treat pseudoptosis breasts? (Photos)

Your glandular ptosis may be treated by a variety of approaches. Your relative skin excess is distributed across the entire lower portion of the breasts, so skin removal and tightening in that area should be part of the plan. Your nipple position may or may not need elevation depending on measurements, but it appears from your side profile view that the nipples are above your inframammary fold so not raising the nipples too much (if at all) is important. Whether or not a vertical approach, a transverse crescent, or a combination of the two (Wise pattern) is preferred depends on your sentiments and your surgeon's flexibility. My recommendation would be for a vertical breast lift (probably without horizontal component to minimize scar) to manage flattening on the front of your breasts and to produce a rounded rather than a "pancake" breast with the most aesthetic shape and nipple projection.

Hi michele511,

I appreciate you reaching out with your question about treating pseudoptosis, especially given your current breast size of 32DD/34D. Your provided history and pictures are helpful in formulating a response.

An important consideration in your case is deciding the desired breast size post-surgery. If you're content with maintaining your current size, a breast lift would be an appropriate approach. However, if you're looking to increase your breast size or achieve more upper fullness, breast augmentation, possibly combined with the removal of some breast tissue at the bottom of your breasts, would be worth considering.

In terms of implants, for optimum results, I typically recommend smooth, high-profile, silicone implants. These tend to provide a more natural look and feel. Placement above the muscle is often ideal for maximizing upper pole fullness. The specific type of breast lift that will be most suitable for you, whether a lollipop or an anchor incision, will partly depend on the size of the implant you choose. It's important to note that more enduring results are typically achieved with lollipop, vertical, or anchor mastopexy compared to crescent or wedge mastopexy.

I hope this guidance has been helpful in addressing your concerns about pseudoptosis with 32DD/34D breasts. It's crucial to consult with an experienced, board-certified plastic surgeon who has a strong background in breast surgeries. They can provide personalized advice and ensure that the chosen procedures align well with your aesthetic goals.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

You have ptosis of your breasts and need at least the vertical lift to lift and reshape your breasts. Small implants placed behind the muscle can help give more upper breast fullness.