Ptosis is a sagging condition where the breast both falls on the chest, and points downward. Cosmetic surgeons determine the degree of Ptosis according to the position of the nipple relative to that of the inframammary fold – the fold under the breast. Officially, a young breast that is not sagging is defined as one where the nipple sits above the level of the Inframammary fold, where the bra wire goes.

The following are the degrees of ptosis that your cosmetic surgeon will considering in determining your need for a Breast Lift:

Grade I- Minor Ptosis
Nipple is at the level of the Inframammary fold.

Grade II- Moderate Ptosis
Nipples have dropped below the level of the breast crease, but still higher that the majority of he breast mount.

Grade III- Advanced Ptosis
Nipples have dropped below the level of the Inframammary fold, and just at the level of maximum breast projection.

Grade IV- Severe Ptosis
Nipples have dropped below the level of the Inframammary fold, and below the breast mount. They are pointing to the floor!

Pseudo-Ptosis or Glandular Ptosis
Nipple is at the normal level, but the breast Parenchyma has slid down below the level of the Inframammary fold, giving the appearance of a bottomed-out breast.

During Concentric Mastopexy, also known as the Benelli Lift, the plastic surgeon makes circular incisions around the areola, and removes the doughnut-shaped skin between the two incisions. The plastic surgeon then moves the nipple and areola upward and stitches surrounding skin around the areola. The Benelli Lift works best in women with smaller breasts and minimal sagging. A variation of this is the Benelli-Lollipop, which has straight incisions from beneath the areola to the mammary fold, rather than the circular ones. This is considered appropriate for women with Medium Ptosis.

Anchor-Shaped Mastopexy is the most common, and also the most invasive, Breast Lift procedure. Your cosmetic surgeon will make an incision above your nipple, in the shape of an anchor, with a circle at the top. The nipple is placed in the circle at the top of the "anchor," forming the shape of the new breast. The lines at the bottom form the lower contour of your breast. The plastic surgeon sutures the skin around the areola, vertically down to the chest, and side to side along the newly created bottom fold.

Most women ask me weather a breast implant can lift their breast? The answer is yes; but other things might have to be done, as well. Although implants do lift breasts they are not mandatory. After pregnancy and with age, most women lose breast volume. This occurs disproportionately making breasts look empty on the upper part of the chest. In a person that has significant loss of breast volume and would like to become fuller, I recommend breast augmentation in conjunction with a lift.

The second most common question that I get asked is how much scaring is involved with breast lift surgery? Although all surgeries do leave scars, a surgeon can place these scars in areas that are not as noticeable. For example, in some women the breast can be lifted just placing the scars at the periphery of her areola, which is the dark area around the nipple. This scar is often very difficult to notice after it heals properly. Depending on the extent of the sagging there are times that additional scars need to be also placed. In order to correct severe sagging or ptosis of breasts it is necessary to remove extra loss skin, which will require additional scars such as those of breast reduction.

Can breasts sag after a breast lift? As discussed at the beginning of this article, sagging depends on the size of the breasts, pregnancy, gravity, and time. This applies to breasts even after a lift. Despite this, there are ways of lessening the rate of breast sag after surgery. Your plastic surgeon can discuss this with you during consultation. Dr Younai has helped many patients from Beverly Hills and other part of Los Angeles, seeking breast lift surgery.

How long does a Mastopexy last? Any surgery can not be considered permanent as far as gravity goes. Gravity will prevail and you will sag, period. Although we can attempt to slow its process by wearing bras, staying out of the sun and healthy eating. Whatever the case, a woman's breast tissue, in 95% of cases, will sag eventually. 

Regardless of having had  Mastopexy, a breast will sag again. It may be years from now, but you may need an additional Mastopexy, depending on your habits of bra wearing, this may be slower. The type of a breast lift also affects the longevity of your lift. Usually, an Inverted–T Mastopexy will have a more lasting result than a Benelli Peri-areolar Mastopexy.

The size and weight of your breasts also affect the natural progression of sagging. The heavier your breasts are, or the larger the implants, the faster your breasts can sag, if you don’t wear adequate breast support. Finally, the elasticity of your skin and breast tissue impacts the rate of their sagging. Women who have thin and sun damaged breast skin with many stretch marks have very poor skin and breast elasticity and will need a revision breast lift sooner.

In the following sections Dr. Younai reviews your treatment options for breast augmentation or enlargement, including pros and cons of each procedure, potential risks and complications, recovery course, pre and post operative instructions, and esthetic outcomes. There are also many before-and-after pictures and high resolution images of breast augmentation available in our photo gallery.