>A breast lift is customized to your goals, concerns, and the severity of ptosis experienced. In general, the procedure involves removing redundant skin to reshape the breasts and lift their position on the chest wall, resulting in elevation of the nipple-areolar complex to a more optimal position. Breast lift surgery can not only improve the firmness of the breasts, but it also has the ability to enhance projection. There are two types of breast lift procedures: the circumareolar mastopexy and the vertical mastopexy.
Why Do Breasts Sag?
Sagging breasts, medically referred to as breast ptosis, are a natural change that many women experience at some point in their life. This condition can occur gradually, or more noticeably after significant life events such as pregnancy and breastfeeding. Several factors contribute to breast sagging, including:
- Aging: Aging naturally reduces the body’s production of collagen and elastin, which are proteins that keep the skin firm and resilient.
- Pregnancy & Breastfeeding: Pregnancy and breastfeeding are also significant contributors, as the breasts enlarge to produce milk and then shrink afterward, stretching the skin and ligaments in the process.
- Weight Fluctuations: Gaining and losing weight repeatedly can loosen breast skin.
- Genetics: Your skin type, elasticity, and breast size all influence how breasts change over time. Some women are also predisposed to sagging earlier in life depending on skin type, breast size, and tissue composition.
- Gravity: Over the years, the constant downward pull leads to gradual sagging.
While breast sagging is completely normal, it can sometimes affect self-confidence and body image. Breast skin irritation can also be a concern, as hanging skin and tissue can sometimes cause issues with skin health and hygiene.
Can I Rejuvenate My Breasts Without Surgery?
Many women come across fitness routines or online programs that promise to “lift” sagging breasts through exercise. While strengthening the chest muscles can improve posture and add definition to the upper body, it’s important to understand that exercises cannot lift or restore support for the breast tissue. Breasts are composed of fat, glandular tissue, and skin, not just muscle. This means that while working out may enhance the tone of the underlying pectoral muscles, they cannot tighten stretched ligaments or reposition breast tissue that has descended over time.
Exercise and other non-surgical techniques unfortunately cannot address the anatomical factors causing the breasts to droop, but breast lift surgery can be a highly effective treatment to rejuvenate aging breasts.
Types of Breast Lifts
Circumareolar Breast Lift
The circumareolar lift, also known as the “donut” or “Benelli” mastopexy, involves removing skin in a circular pattern around the areola. This results in a scar that is restricted to the areolar border, and is an advantage of the circumareolar technique. Disadvantages include the lack of a significant nipple/areolar elevation, a flattening effect on breast shape, potentially wider areolar diameters, and more irregular, wider scars. For these reasons, Dr. David Bottger prefers to utilize this procedure only when a limited amount of lift is required.
Vertical Mastopexy
The other procedure is called the vertical mastopexy. Skin is removed from around the areola to the inframammary fold in a teardrop shape, resulting in a lollipop-shaped scar. This is the most commonly performed procedure, as the technique is applicable to all levels of breast ptosis. It produces excellent shaping and nipple elevation, generally resulting in finer, more predictable scars than the circumareolar approach.
Combination Treatment – Breast Lift with Implants
Depending on whether or not you would also like to restore lost breast volume, incorporating the addition of implants for a joint breast augmentation and breast lift procedure can provide an increased size as well as more upper fullness to the breasts, achieving more comprehensive results. Dr. Bottger, our Philadelphia-based breast surgeon, can speak with you about your concerns and develop a treatment plan to attain your desired look.
Surgical Procedures for Firmer Breasts
For women seeking a significant and lasting change, aesthetic surgery remains the most effective way to firm and lift the breasts. Depending on a patient’s overall goals and needs, those who have moderate to severe sagging can benefit from:
- Breast Lift (Mastopexy): A breast lift (mastopexy) is the gold-standard treatment for sagging. During this procedure, excess skin is removed, breast tissue is reshaped, and the nipple and areola are repositioned to a higher, more youthful placement on the chest.
- Breast Lift with Implants: For women who not only have sagging but also a loss of breast volume, a breast lift with implants can restore fullness while providing rejuvenation, offering both shape and projection.
- Breast Reduction: In cases where the breasts are overly large and heavy, a breast reduction may be recommended. This procedure removes excess tissue and skin while reshaping the breasts into a firmer, more proportionate breast size, simultaneously alleviating physical discomfort and creating a more youthful contour.
The right solution to rejuvenate your sagging breasts depends on your unique situation and goals. The best way to determine which approach is right for you is to consult with a board-certified plastic surgeon like Dr. David Bottger who can evaluate your concerns, explain your options, and help you achieve a more youthful breast shape that aligns with your personal goals.
Editor’s Note: The original version of this blog was published on April 10, 2020.