Any woman who has ptosis, or sagging of the breasts, is a candidate for breast lift. Conditions that contribute to the ptosis of the breasts include:



Aging: As women age, there is a gradual reduction in skin elasticity, as well as the stretching and elongation of the Coopers Ligaments, which are responsible for holding breast tissue up against the chest wall. The breast tissue itself also changes with age from mostly firm, fibrous milk glands to fatty tissue, which is soft and saggy. This change accelerates with menopause, and the gradual reduction of estrogen levels.

Pregnancy and Nursing: enlargement of the breasts during pregnancy, followed by their deflation after the end of breast feeding, also stretches the Coopers Ligaments, reducing fibrous tissue, breast volume and leading to ptosis.

Large Breasts and Implants: The tissue and skin of inherently large breasts, or those that have been augmented with implants, stretch out from the breast weight, resulting in sagging.

Weight Loss: Rapid weight loss or dramatic fluctuations in body weight also cause the skin's elasticity and breast tissue to decrease.

There are a variety of "litmus" tests to determine if the degree of sagging in your breasts is advanced enough to warrant a procedure. Many lay persons define breast sagging by how far the breast tissue descends on the chest wall. Plastic surgeons, however, define breast sagging based on the position of the nipple in relation to the breast mount or Inframammary Fold.

Degrees of sagging, each defined specifically by plastic surgeons are: Mild Ptosis, where the nipple is at the level of the Inframammary Fold; Moderate Ptosis, where the nipples have dropped below the level of the breast crease, but are still higher than that of most of the breast mount; Advanced Ptosis, where the nipples have dropped below the level of the inframammary fold and are just at the level of the maximum breast projection; and Severe Ptosis, where the nipples have dropped below the level of the inframammary fold, and below the breast mount, so they are pointing to the floor.

Other "tests" for sagging include "The Pencil Test" that defines sagging breasts as those which hold a pencil in place under the breast under-fold. While many women consider some degree of sagging as normal and natural, The Bra Test determines that breasts which fall upon removal of the bra are Ptotic breasts.

Together, you and your plastic surgeon will determine which kind of Breast Lift procedure is best for you. During a Crescent Lift, the cosmetic surgeon removes a crescent-shaped piece of tissue above the areola and restores the tissue to a higher position. This creates a minor lift for patients who have Mild Ptosis. One risk of this technique is a slight egg-shaped areola for patients who have heavier breasts and do not wear good quality supportive bras following surgery.

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.

Sometimes, breast lift is combined with a breast augmentation (with an implant) procedure to restore breasts to a fuller and enhanced appearance. At other times, breast Lift is combined with breast reduction surgery, with the aim of lifting the breasts while reducing their size to a more proportionate one. One alternative to a breast Lift is a nipple lift alone. While this will not raise the breast itself to the fullest extent possible, it has the advantage of leaving a scar only around the upper half of the areola.