What grade ptosis and what procedure is recommended? (Photos)

Question

Trying to figure out what grade pitosis iam at and what procedure would help.

Mert Demirel, MD · Answer

From the photos, this appears to be significant breast ptosis, likely grade 2 to grade 3, but the exact grade depends on where the nipple sits compared with the inframammary fold on an in-person exam.
When the nipple is at or below the breast fold and the lower breast skin hangs significantly, the most effective procedure is usually a breast lift. A lift can raise the nipple-areola position, remove extra skin, reshape the breast, and improve the overall breast position.
If the breasts are also too large or heavy, then a breast reduction with lift may be better than a lift alone. If the breasts feel deflated and you want more upper fullness, an implant or fat grafting may be discussed, but this depends on your goals and tissue quality.
In your case, an anchor-pattern lift or reduction-lift would likely be more powerful than a small scar lift. A periareolar or donut lift would not be enough for this degree of sagging and could flatten the breast or stretch the areola.
The best next step is an in-person consultation to assess nipple position, breast volume, skin quality, and whether you want to stay the same size, become smaller, or add fullness. That will determine whether the right plan is lift alone, reduction-lift, or lift with volume restoration.

Ted Eisenberg, DO, FACOS, FAACS · Answer

Questions to improve breast appearance: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 desired. 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 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

Justin Yovino, MD, FACS · Answer

You are a grade 3 ptosis since your nipple is inferior to the inframammary fold (IMF). For best results, the treatment is an anchor pattern mastopexy.

Grade 1 ptosis refers to ideal position of the nipple superior to the IMF. Grade 2 is at the IMF. Grade 3 is inferior to it.

A mastopexy is a breast lift. A lift with a scar only around the areola are very limiting and commonly dissatisfying. Circumvertical (lollipop) lifts are with the scar around the areola and straight down in the center of the lower part of the breast. Those commonly leave too much tissue in the lower part of the breasts and still look droopy even though the nipple and areola are fully lifted. An anchor pattern lift fully addresses the excess skin in the vertical and horizonal directions.

We perform breast lift in the office under local anesthesia. You're a great candidate.

Gulcin Nujen Cardak, MD, FEBOPRAS · Answer

Although an assessment based solely on photographs may not provide a 100% definitive result, your nipples appear to be positioned below the inframammary folds. Therefore, it would be appropriate to classify your condition as Grade 3 breast ptosis.Based on the evaluation of your photographs, it also appears that you may be a suitable candidate for a breast lift using a vertical scar technique, without the need for an inverted-T (anchor-shaped) scar. Of course, the final surgical plan can only be confirmed following an in-person examination and a detailed assessment of your breast tissue.

Mehmet Ozdemir, MD · Answer

After reviewing your photos, you appear to be a suitable candidate for a breast lift. A detailed in-person consultation and examination are required to determine the most appropriate treatment plan.

Jeffrey M. Darrow, MD · Answer

Thank you for your photos. It appears that you have a grade 2 to 3 ptosis of your breasts. A full grade 3 ptosis would have your nipples sitting at the lowest portion of your breasts. This means that your breast tissue and your nipple/areola complex sit below the level of the fold underneath your breasts. The first question to answer would be, are you happy with the size of your breasts but unhappy only with their position. If this is true, a breast lift can correct the position of the nipple/areola complex to above the level of the fold under your breasts and lift your breasts. If you are unhappy with both the size of your breasts, as well as the position of your breasts, then a breast reduction, which gives a lift at the same time, could be done to reduce the size of your breasts, and also elevate them to a more youthful, perky position. Have a detailed consultation with your plastic surgeon about these options. Best wishes.

Gary M. Horndeski, MD · Answer

You appear to have Grade III ptosis. I recommend a breast lift using the Bellesoma. 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. The weight of the breast is transferred to the underlying pectoralis major muscle resulting in long term stability. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Finny George, MD · Answer

Hi, thank you for sharing your question. Based on these photos you have grade 2 ptosis and would be a good candidate for a lift assuming that you are medically able to undergo surgery.

Yasemin Aydinli, MD · Answer

From your photos this looks like grade 3 (advanced) ptosis, where the nipple sits at the lowest point of the breast and points downward. At this grade a formal lift is needed to reposition the nipple and tighten the skin, using either a vertical "lollipop" scar or an inverted-T (anchor) scar depending on how much loose skin there is. Whether you also need an implant comes down to the look you want: if you would like a fuller, rounder, more pronounced upper cleavage (decollete), an implant placed at the same time achieves that. But if you are happy with a natural shape and do not mind the upper pole being softer and not perfectly round, the lift on its own is enough. One reassuring point is that the scars are exactly the same whether or not an implant is used, so adding volume does not add to your scarring. A quick in-person measurement of your nipple position and skin would confirm the precise technique.

Semih Yildiz, MD, FEBOPRAS · Answer

The photos suggest moderate to significant breast ptosis, but the exact grade is best confirmed in person by measuring the nipple position relative to the inframammary fold and looking at skin quality and breast volume.

In this situation, the main corrective procedure is usually a breast lift, not an implant alone. A lift can raise the nipple-areola position, reshape the lower pole, and remove extra skin. If you also want more upper-pole fullness or larger size, an implant or fat transfer may be discussed with the lift, but adding volume without lifting the skin usually does not correct this degree of drooping. A plastic surgeon can recommend the scar pattern after examining how much lift and reshaping are needed.

What grade ptosis and what procedure is recommended? (Photos)

Answers (13)

More Breast Lift Questions

Am I a candidate for a breast lift? Would I be able to have a crescent or donut lift? (Photo)

Breast lift vs lift with implants - how can I achieve perky results with upper pole fullness?

Will a breast lift and tummy tuck fix the breast sagging and stomach rippling? (Photos)

38, no children. Would a breast lift only provide the results I am looking for? (Photos)

Do I need a lift or would implants alone be okay? (Photo)

Unable to breastfeed from left breast 3.5 years after breast lift - can anything be done?

WE SEND PRETTY
EMAILS