Psuedoptosis? What can I expect from results without a lift? (Photos)

Question

I have a consult this weekend but am trying to prepare- Does this appear to be psuedoptosis? I really did not want to have to get a lift but after over researching- I’m concerned that after implants I’ll have a ‘matronly/saggy’ look. I’d like to go larger, and while I don’t have to have a ‘porn star/basketballs’ look I definitely want them to be considered sitting pretty. My other concern is - do I have an overly wide set chest? And is this going to leave large gapping/east west looking breasts after implants? I’ve done the simulator and it looks ridiculous and I’m having a hard time understanding what’s realistic and what isn’t. Thank you so much!

Frank Agullo, MD · Answer

The result of the consultation turns on a single measurement: your nipple level compared to the inframammary fold (IMF).

If the nipple rests at or above the IMF (like you), even if the breast tissue itself sags below this line, then true pseudoptosis is present. An implant will naturally fill the inferior portion of the breast envelope and elevate the nipple to a normal position, eliminating the need for a lift scar. This is, perhaps surprisingly, the most frequent reason patients are talked into a lift they genuinely do not need.

A doughnut lift would help to improve symmetry and give an additional lift if desired.

#StayBeautiful,

@RealDrWorldWide

Ted Eisenberg, DO, FACOS, FAACS · Answer

Do I need a breast lift? You might not need one. 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. 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. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Semih Yildiz, MD, FEPOBRAS · Answer

Implants can add volume, but they do not reliably lift a breast when the nipple/areola and lower pole sit low on the breast mound. In your photos, the main visible concern is mild to moderate droop with lower-pole skin laxity and some natural spacing between the breasts; an in-person exam is needed to confirm whether this is true ptosis, pseudoptosis, or a combination.

If the nipple position is acceptable and the goal is mainly upper-pole fullness, augmentation alone may be reasonable, but it can also make a low or wide-set shape more obvious if the implant is too large or poorly matched to your base width. If you want the breast to sit higher or the nipple centered on the mound, a lift or staged plan may give a more predictable shape than trying to fill it out with a larger implant alone.

Brian K. Reedy, MD · Answer

Thanks for your question! I don't think you have much ptosis or pseudoptosis. You should do just fine without a lift if you pick the right implant. I do think you will always need a bra to have kissing cleavage but you should get better cleavage with a moderate profile of a moderate size. Best of luck!

Kadir Berat Oyur, MD · Answer

I completely understand your concern, and please let me reassure you that seeing a visible stitch pop up on your incision line at three months post-op is an incredibly common part of the healing process. Most modern surgical closures utilize deep, absorbable sutures designed to slowly dissolve over several months; occasionally, rather than breaking down completely beneath the skin, a small fragment can work its way to the surface as the tissue remodels. This is simply your body's natural way of shedding the material, and as long as the surrounding area isn't showing signs of active infection like spreading redness, heat, severe pain, or heavy discharge, it is entirely manageable. I highly recommend having an in-person follow-up or sending a clear, close-up photo to your surgical team so they can quickly clip the exposed tip for you, which will allow the skin to close up smoothly and comfortably.

Psuedoptosis? What can I expect from results without a lift? (Photos)

Answers (5)

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