Ptosis Grade 1 No Lift? (photo)

Question

I have been looking up ptosis grades because I've been told I would need a lift and other say I don't! So I looked up how to identify what grade I am and I think I'm only a level 1!! I am 22, 3 year old son who I breast feed for 23 moths. I'm 5'8 and 150lbs. I want to be a full D or small DD. do you think I can get away with only implants and no lift? Or a small lift and not a full lift?

York Jay Yates, MD · Answer

Although your droop is grade one by nipple position, the lower breast has droop. If you are OK with a little droop of the gland you may be a great candidate for implants alone without a lift. I would recommend using 3D imaging to help your plastic surgeon communicate the degree of droop that would remain after implants alone to help you with this decision.

Austin Hayes, MD · Answer

Thank you for your question. There are some women who will benefit from adding a breast lift to a breast augmentation. In general, if your nipple is located at or above the crease below your breast then a lift is typically not needed. In addition to nipple position, measurements are also used to determine when to add a lift. It's important to know the breast implants do not lift the nipple to any significant degree, so you can't escape the lift by using a breast implant. Breast sagging is a spectrum and women with mild/moderate sagging can sometimes go either way. In this situation, I typically recommend breast augmentation as an initial procedure, waiting six months, and then only performing a breast lift if it is truly needed. When considering breast augmentation make sure you find a board certified plastic surgeon who will take the time to answer all of your questions and explain all of your options, so that you can decide which procedures are right for you.

Jerome Edelstein, MD · Answer

You may not need a breast lift, however to determine this you would need a consultation with a surgeon who has experience with performing breast augmentation on breasts affected by mild to moderate sagging. You can consider Allergan Inspira Truform 2 implants with a narrower base width for more projection.  Please see an experienced board certified plastic surgeon to find out whether you are a suitable candidate. Best of luck.

Kenneth Hughes, MD · Answer

Though an exam will be necessary, I suspect the main issue with your breasts will be the degree of residual skin laxity in the inferior aspect of the breasts after the implants are placed. The lift can be performed later is there is any doubt about its necessity. Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA

Amy T. Bandy, DO, FACS · Answer

Hi KristyRae! You have a great question, that does not have an easy straight forward answer. But yes, you could definately have a breast augmentation without a lift, but it all depends on what result you are looking for. You have glandular ptosis, and implants alone without a lift will give you more fullness, but your breasts will still be low on your chest wall, just larger. If you are looking for perky breasts with upper pole fullness, then you would be better served with a lift and augmentation. You need to go in for a consultation where you can be shown examples of before and after photos of breasts similiar to yours so you can see what either choice would give you.

Rigo J. Mendoza, MD · Answer

Thank you for the pictures. You have psuedoptosis or glandular ptosis. This means your nipples are OK but the gland is sagging below your crease. Given the fact that you want to be a D or DD, your should be fine with just implants.

Joshua Cooper, MD, FACS · Answer

-Although your nipple position might be in an acceptable location, you do appear to have a fair amount of glandular ptosis, which is not uncommon after pregnancy and breast feeding. Glandular ptosis refers to an excess amount of sagging breast tissue below the nipple and inframammary crease.  

	-Therefore, breast augmentation without a lift would likely necessitate the need for a very large implant, and if a large implant is not used, chances are your breast shape will not be as pleasing as it could be with a breast lift.

	-Thanks for providing your photos, but I would definitely recommend meeting in person with a board certified plastic surgeon.  He/she will examine you thoroughly and will be able to provide more information to guide you towards the breast size/shape that you desire.

	-Best of luck to you!

Vincent N. Zubowicz, MD · Answer

A breast augmentation will probably obviate the need for a mastopexy based on the photograph provided. The larger the implant the more likely the ptosis is to be camouflaged.

Kenneth R. Francis, MD, FACS · Answer

Dear Kristy Rae,

	As pointed out, you have a condition known as glandular ptosis.  I usually recommend a lift along with augmentation for this condition.  You can augment without the lift, but your breasts will remain low lying on your chest wall.  Good luck!

Richard J. Brown, MD · Answer

Hi and thank you for your posted question. It always makes me nervous when a patient or surgeon asks if they can "get away" with just an implant. You have basically identified the problem right then and there with that statement. There is no such thing as getting away with just an implant. You have to clearly define what your goals are. If you do not mind lower hanging breasts then maybe you could just have implants alone. If you desire higher, fuller, more rejuvenated breasts then likely you need an implant with a lift or a lift alone. The best way to determine what is best for you is to see a board certified plastic surgeon by the American Board of Plastic Surgery who does lots of breast surgery and they will give you the best advice. Seek as many opinions as needed. If you need to see ten surgeons to get the average then do so. Usually I have found that if you see 2-4 you will find the one you like and trust and who understands your goals. Go with that one.

Ptosis Grade 1 No Lift? (photo)

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