breast ptosis Archives - DeLuca Plastic Surgery - Albany NY

Correcting Tuberous Breasts with Surgery

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What Are Tuberous Breasts

Tuberous breasts is a condition where the breasts form into a tube-like shape because of constriction at the base of the breasts during development. The breasts also tend to develop farther apart and unevenly than a normal chest. The breasts are often characterized by enlarged areolas and sagging. Although this condition may prevent a woman from breast-feeding, it doesn’t lead to any other pregnancy or fertility related issues.

Women with tuberous breasts may range from type one, which is the mildest to type five, which is the most severe. With type one, only the lower inside of the breast is constricted. In the most severe cases, the entire breast is constricted and can be physically deforming.

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Do I Really Need A Breast Lift?

The decision to do a breast augmentation without lift versus a breast augmentation with a breast lift, however, is less based on patient preference and more dictated the saginess, the nipple position, and the ratio between the breast volume and the amount of excess skin that is present.

How Ptotic Are My Breasts?

The gold-standard method of assessing the need for a breast lift is the “pencil test.” Standing in front of a mirror, lift the breast and lay a pencil in the fold under the breast and allow the breast to settle over the pencil. Look at the position of the nipple in relation to the pencil.

Pencil Test For Determining Degree of Breast Ptosis
Pencil Test For Breast Ptosis

The lower the nipples and breast are below the pencil and the more excess skin you have, the greater the chance you will need a breast lift and the more of a breast lift you will need. If your nipple and a majority of your breast are at or above the pencil (Normal), you will likely get a great result from a breast augmentation alone. Larger implants can shift this equation slightly for patients that have borderline ptosis (Grade 1).

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Breast Q&A: To Breast Lift or Not to Breast Lift, With or Without Implants?

Perhaps the two most frequently asked questions I receive from women interested in breast enhancement surgery are:

  1. “Do I need a breast lift with or without implants?”
  2. “Can I get an ideal result with just breast implants?”

As with most operations, it’s always best to get things right the first time around. And when it comes to breasts, getting it right doesn’t typically mean looking great for only a few short years before the effects of gravity and time undue all the good work that was done.

So when I advise my mastopexy (breast lift) patients on what their options are for achieving the best and most youthful looking breast possible, I always make sure that they have a crystal clear understanding of what their surgery options are and how each option will look and feel over time (re: 1 year, 5 years, 10 years etc.) rather than just what they can expect to look like during the immediate post-operative period.

9 times out of 10, the best path forward is clear and the patient is in full agreement that the procedure’s pros outweigh any cons that may inherently be involved (e.g. a slightly longer incision in return for a stronger, more longer lasting lift).

Of course, not every breast fits perfectly into one of the the breast types described below, but most do, so hopefully readers will find the following example photos and procedure recommendations helpful and/or informative , especially if they are considering their options for a breast lift with or without implants/augmentation.
 

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Breast Q&A: What’s the Best Way to Correct Grade 1 Breast Ptosis (Sagging)? Implant, Lift or Both?

Question – What is the best way to correct breast ptosis, high or moderate profile implants, a breast lift or both?

Stage I Breast Ptosis

Breast sagging after pregnancy

I am 36 years old, breastfed 2 kids, and have lost volume in my breasts. I have some sagging but my nipple is still over the fold. I weigh 130 pounds and am very fit and toned.

I am 5″4″ and my breast size is a 34B. Before my kids I was a 34C cup. When I was breastfeeding I was a 34D cup. I would like to be a D cup and wonder what type of procedure would be best to correct my ptosis?


Answer – Since you have a small amount of glandular ptosis (pseudoptosis), you not only want to fill-OUT, but lift-UP a little as well. Therefore, my approach would be a dual plane breast augmentation, which would fill out the inferior/lower pole nicely, give you muscle coverage across the upper two thirds of the breast and a nice, slightly lifted appearance.

More specifically, given your body measurements and photo (which shows pseudoptosis with mild Grade 1 ptosis), I suspect that 450cc moderate plus profile implants are needed to give you both the breast size (D cup) and breast lift you desire.

How To Classify/Grade Breast Ptosis

Simply put, grade 1, 2 or 3 glandular ptosis, which refers to how far the areola is sagging below the inframammary fold beneath the breast, the lower attachment point of the breast to the chest wall.

  • Grade 1: Mild Ptosis – The nipple is at the level of the inframammary fold, but most of the breast tissue is below the nipple.
  • Grade 2: Moderate Ptosis – The nipple is located below the inframammary fold and below the majority of the bottom breast tissue.
  • Grade 3: Advanced Ptosis – The nipple is far below the inframammary fold and points towards the floor.
  • Pseudoptosis – The nipple lies above or at the level of the inframammary fold while the majority of the breast has descended below the level of the fold. This is not true ptosis, or sagging.

Diagram of breast ptosis (drooping/sagging) degrees/stages

The degrees/stages of breast ptosis (drooping/sagging)

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