Published April 15, 2021 By Dr. Adam Lowenstein

Age is more than a number; it is a state of mind and body. Your mind may feel vibrant and youthful but your body may be showing you otherwise. Cosmetic aging cannot be avoided. We also have no way of knowing exactly when certain concerns may arise. Breast ptosis is one such concern. The word ptosis comes from the Greek word “falling.” It is an accurate term to describe the sagging that typically affects the breasts at some point.

Breast ptosis can occur on a scale. It is a result of the stretching of what are called Cooper’s breast suspensory ligaments. During the early years of adulthood, especially when breasts are smaller and before pregnancy, these ligaments are short and tight. Pregnancy-related breast growth, breastfeeding, and changes in estrogen levels can alter the density of the breasts. Heavier breast tissue is more susceptible to the effects of gravity that cannot be escaped. The more the Cooper’s breast suspensory ligaments stretch, the more severe ptosis becomes. Severity may range from mild ptosis, in which the nipple and areola still sit above the inframammary crease to severe ptosis, in which the nipple and areola are at the bottom of the breast, below the inframammary fold. Not sure where that fold is? Place a pencil where the bottom of your breast meets your chest. Then let the breast tissue sit normally. This can help you observe how much your breasts sag.

In 2019, mastopexy, breast lift surgery, increased 3% from the previous year. It increased 114% from 2000, outpacing the growth in breast augmentation.

What is a breast lift?

Breast lift surgery is a procedure that reshapes the breast mounds to achieve better shape, size, and position. During the procedure, the surgeon removes extra skin and, if needed, glandular tissue. The nipple-areola complex may also be repositioned or resized. A breast lift can often coincide with ancillary procedures like breast augmentation. Depending on the desired outcome and extent of correction needed, the surgeon considers a few different mastopexy techniques. Each is referred to in terms of its incisions.

Crescent Mastopexy

The crescent mastopexy technique removes a half-moon-shaped section of breast skin from the upper edge of the nipple-areola complex. The nipple and areola are repositioned higher, resulting in a lifted appearance. This technique can be done with breast implant surgery and is suitable for a subtle lift.

Circumareolar Mastopexy

The circumareola mastopexy technique makes an incision around the nipple-areola complex. A second incision made several centimeters away from the first allows the surgeon to remove a donut-shaped section of skin in between the two. The outer edge of the skin is tightened to the inner incision to lift the breast. The surgeon may also place internal sutures deep in the breast tissue. This type of mastopexy achieves more of a lift than the crescent incision but is still relatively mild.

Vertical or Lollipop Mastopexy

Incisions for this technique are made around the nipple-areola complex and down the front, center of the breast to the inframammary crease. Tissue is removed from the bottom region of the breast, pushing the nipple and areola upward for a lifted appearance. With part of the incision hidden around the colored skin of the areola, the lollipop mastopexy achieves a more significant lift with minimal scarring.

Anchor or Inverted-T Mastopexy

This breast lift technique involves an incision down the front, center of the breast with a perpendicular incision along the inframammary crease, like an inverted T. This incision technique allows for greater tissue reshaping and maximum lifting but it does result in the most scarring. Keep in mind, though, that breast lift scars are hidden beneath a bikini top or bra.

Learn more about which breast lift technique may be ideal for you. Call our Santa Barbara office at 805.969.9004 to schedule your consultation with Dr. Lowenstein.

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