How Do You Address Breast Ptosis? – A Breast Lift Mastopexy, Breast Implants or Both?

Breast ptosis, or sagging breasts, can be addressed through various methods, including a breast lift mastopexy, breast implants, or a combination of both, depending on the specific needs and goals of the individual.

Breasts that have lost volume and have excess loose skin are known as ptotic breasts or breasts with ptosis (pronounced ‘tosis’ – the p is silent!). Ptosis results from losing the inevitable battle between skin elasticity and age.

Download the 2023 Breast Lift Mastopexy Surgery Guide

This complete guide to Breast Lift Surgery covers everything you need to know about this procedure, including:

  • Your surgery explained
  • How to assess if you are a good candidate.
  • Planning for your surgery
  • Answers to most frequently asked questions.
  • Before and after gallery
  • Read more about Breast Lift
Breast Lift Guide Download

Download our 2023 Breast Augmentation Mammoplasty Guide

This complete guide to Breast Augmentation Surgery covers everything you need to know about this procedure, including:

  • Your surgery explained
  • How to assess if you are a good candidate.
  • Planning for your surgery
  • Answers to most frequently asked questions.
  • Before and after gallery
  • Learn more about Breast Augmentation
Breast Augmentation Guide Download

Do you have ptotic breasts?

Breast ptosis, commonly called sagging breasts, is a standard ageing process. The severity of breast ptosis is typically categorised into different grades. Some signs and ways to tell if you have ptotic (sagging) breasts include:

  • Nipple Position:
    • In some individuals, the nipples typically point forward or slightly upward. In breast ptosis, the nipples may point downward.
  • Breast Shape:
    • In mild cases of ptosis (Grade 1), the breasts have a more common teardrop shape.
    • In moderate to severe cases, the breasts may have a changed shape.
  • Breast Position:
    • Breasts with ptosis may hang lower.
    • The degree varies depending on the grade of ptosis.
  • Skin Elasticity:
    • Reduced skin elasticity is a frequent factor in breast ptosis.
    • Loss of skin elasticity can affect breast support.
  • Creases and Folds:
    • An additional fold or crease in moderate to severe ptosis may develop underneath the breast.
  • Tissue Volume:
    • Loss of breast volume and firmness is often seen in ptotic breasts.

It’s helpful to note that breast ptosis can occur for various reasons, including ageing, pregnancy, weight fluctuations, genetics, and breastfeeding.

Why does Breast Ptosis occur?

Breast ptosis happens due to a process called “Breast involution.”

Breast involution is a common occurrence when the milk-producing system within the breast undergoes a reduction because it is no longer needed.

This happens after stopping breastfeeding or shortly after pregnancy without breastfeeding. It can also occur during menopause.

When the tissues within your breast start to shrink, your breast may lose its shape.

Breast Ptosis: What causes it?

Factors that can contribute to breast ptosis:

  • Gravity
  • Lack of breast support
  • Smoking (may affect skin)
  • Pregnancy or weight changes (can affect skin elasticity)
  • Multiple pregnancies (can affect skin)
  • Pre-pregnancy breast size
  • Age-related changes in breast tissue

    The Severity of Ptosis Can Depend on Skin Elasticity and Breast Density

    Some patients’ breasts are denser than others. Your breasts are made from both heavy breast tissue (like mammary glands) and lighter fat.

      • The ratio of tissue and fat affects breast density, which may play a role in ptosis.
      • Dense breasts may change more over time, along with other factors.

    How to classify Breast Ptosis

      • Grade 1 Ptosis – MILD – Shape Malformation

      • Grade 2 Ptosis MODERATE – No Bra Support/running is a problem

      • Grade 3 Ptosis SIGNIFICANT – Size change (Stretched post-pregnancy or after significant weight gain/loss)

      • Grade 4 – Allotrophic Skin – Poor collagen strength

    Many patients considering a breast lift mastopexy have moderate or advanced ptosis. Some may feel their breasts have changed after breastfeeding.

    Ptosis - Breast Ptosis degrees of droopiness

    There are several surgical solutions for the Ptotic Breast

      1. Breast Lift without implants

      • A Breast Lift Mastopexy is a surgical procedure designed to lift and change the shape of the breasts.
      • It involves removing excess skin, tightening the surrounding tissue, and moving the nipple and areola.
      • This procedure may suit individuals with excess skin who are satisfied with their breast size and shape.

    2. Breast AugmentationBreast Implants

      • Breast Augmentation Mammoplasty involves the insertion of breast implants to increase breast size and volume.
      • While this procedure can alter the fullness of the breasts, it does not address significant Ptosis alone.
      • It is an appropriate choice for individuals who want larger or fuller breasts.

    3. Breast Lift with implants:

      • In some cases, individuals may choose from both a breast lift mastopexy and breast implants.
      • It may be suitable for those who wish to both lift and increase the size of their breasts. The lift provides the requested shape and positioning, while implants add volume.

    The choice between these options depends on factors such as the degree of breast ptosis, the current breast size, the patient’s goals, and the recommendations of a board-certified plastic surgeon. A consultation with a plastic surgeon is essential to determine the appropriate approach for each individual, as it should be tailored to their specific needs and cosmetic goals. It is also helpful to consider the recovery, scarring, and long-term maintenance associated with each procedure.

    Scars from Surgery

    All invasive surgery leaves a scar. Our experienced surgeons are specially trained to reduce the extent of any breast surgery scars.

    We can also use special post-surgical scar minimization techniques including post-op treatment with Fraxel Laser, Healite II LED and our Recovery Packs.

    Our Recovery package contains scientifically proven products to facilitate healing and some ‘feel good’ gifts to help you make the most of your recovery time.

    Scars also usually fade away over time and may settle even further over 12 to 18 months to fully settle.

    Our Plastic Surgeons

    Our Surgeons want to make sure you know your options, and what results to expect from different procedures.

    It is important, to have realistic expectations about what Breast Surgery can and cannot accomplish for your body or breasts. Sometimes 3D Vectra imaging can help you to imagine what you may look like after Breast Augmentation Mammoplasty Surgery or Mastopexy.

Last updated: 28/01/2024
Author profile image
Dr Craig Rubinstein - MBBS, FRACS (Plast)
Dr Craig Rubinstein MBBS, FRACS (Plast), a Specialist Plastic Surgeon, is one of Australia's most respected Melbourne Surgeons for Breast Augmentation, Breast Lift (Mastopexy), Breast Reduction surgery and Abdominoplasty procedures. Using advanced surgical techniques to gain better body contouring and natural-looking surgical results, Dr Rubinstein is highly regarded by peers and patients for best-practice Clinic Patient-care and patient education strategies. He published a chapter on corrective surgery for Breast Asymmetry. Qualifications/Training Fellow of the Royal Australasian College of Surgeons (FRACS) The Australasian Society of Aesthetic Plastic Surgery (ASAPS) The Australian Society of Plastic Surgeons (ASPS) The Australian Medical Association (AMA) American Society of Plastic Surgeons (ASPS) The International Society of Aesthetic Plastic Surgeons (ISAPS) Founder: Coco Ruby Plastic Surgery previously Cosmetic Surgery for Women and Men Bio Page: https://cocorubyplasticsurgery.com.au/dr-craig-rubinstein-plastic-surgeon/

Specialist Plastic Surgeons and ENT (Ear, Nose and Throat) Surgeon

With a wealth of experience and training, our Specialist Plastic and ENT (Ear, Nose and Throat) Surgeons are dedicated to best-practice patient care and education, customising Surgery for each and every patient to best meet their needs and desired surgical outcomes.

Dr Craig Rubinstein
Dr Broughton Snell
Dr Stephen Kleid
Dr Gary Kode

Specialist Plastic Surgeon MED0001124843

Dr Craig Rubinstein

Dr Craig Rubinstein is a Specialist Plastic Surgeon based in Hawthorn East, Melbourne. With over 20 years of surgical experience especially in all areas of Cosmetic and Plastic Surgery, but particularly in breast surgery. These include Breast Augmentation and Breast Reduction as well as Breast Surgery Revision.

Furthermore, he believes that surgical customisation, precision planning and technical expertise help him to provide optimal surgical outcomes for his patients.

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Dr Broughton Snell

Dr Broughton Snell is a Specialist Plastic and Reconstructive Surgeon based in Melbourne, Victoria, Australia. His training in Plastic Surgery took place in Australia and the United States of America (USA).

Dr Snell is a fully qualified specialist plastic surgeon having completed his Fellowship with the Royal Australasian College of Surgeons in plastic and reconstructive surgery.

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Dr Stephen Kleid

Dr Stephen Kleid is an experienced Ear, Nose and Throat (ENT) Surgeon (Otolaryngologist) based in Melbourne with a passion for Septo-rhinoplasty, Septoplasty, as well as, a strong interest in Rhinoplasty Revision.

Dr Kleid trained at Melbourne University, then completed surgical training at various hospitals including Royal Melbourne, Royal Children’s, The Eye and Ear and St Vincents. He worked as a surgeon at the University of Florida Medical school for further experience.

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Dr Gary Kode

Dr Gary Kode is a Specialist Plastic Surgeon, with experience in Aesthetic and Reconstructive Surgery, as well as non-surgical treatments.

Dr Kode is a member of several organisations, including the Australian Society of Aesthetic Plastic Surgeons (ASAPS), The International Confederation for Plastic and Reconstructive and Aesthetic Surgery, and he holds a Fellowship with the Royal Australasian College of Surgeons.

What to do next?

Our Patient Liaison Team can assist with any questions you may have when considering a procedure. You can send in an enquiry form below or call our Melbourne Clinic between 9 am – 5 pm Monday - Friday.

Disclaimer: Results depend on individual patient circumstances and can vary significantly. Results may also be impacted by a variety of factors including your lifestyle, weight, nutritional intake and overall health. Consult your Specialist Plastic Surgeon for details. This information is general in nature and is not intended to be medical advice nor does it constitute a doctor-patient relationship. Surgery risks and complications will be covered in detail during a consultation with your Surgeon.