Many of the cosmetic concerns women have about their breasts have nothing to do with poor breast volume. Issues like breast asymmetry, enlarged nipples or areolas, and droopiness (formally known as breast ptosis) are the most common sources of insecurity for most women. Though all of these variations in breast shape are normal (perfectly symmetrical, perky breasts are actually the exception and not the rule), that doesn’t make them any easier to live with. Most women are so used to seeing flawless breasts portrayed in the media that they’ve developed an unnatural very high standard for what breasts “should” look like. This can make it difficult to accept having breasts that are uneven or saggy.
According to a survey conducted in England, 30 percent of women say that they “hate” their breasts, and the most-cited reason for this dislike is breast sagginess. The extreme self-consciousness that arises from having breast ptosis can make it difficult to be intimate; it can also restrict one’s fashion choices. This is why many women decide to have breast lift surgery: Breast lift surgery (also called mastopexy) can completely reshape the breasts, making them perkier and more symmetrical. It can also be used to shrink overly large areolas.
What Causes Breast Ptosis?
Though we usually associate drooping breasts with old age, breast ptosis can actually occur during any stage of life. It also affects every type of breast; you don’t need to have especially large breasts to experience this condition. Sagging breasts can develop due to any of the factors outlined below:
Some women naturally develop breasts that are oblong in shape rather than round. This may result from a congenital abnormality (e.g., tuberous breasts) or a normal, inheritable variation in breast shape.
Pregnancy and Breastfeeding
Pregnancy is the leading cause of breast ptosis in younger women. It’s not uncommon for the breasts to grow three full cup sizes larger during pregnancy, but this extra volume doesn’t usually remain in place after pregnancy. Many women report that their breasts are actually smaller after breastfeeding than they were before pregnancy.
This increase and decrease in breast size is so rapid that the skin has no time to adjust to the change. It’s stretched so abruptly that it becomes damaged and cannot bounce back to its prior shape. The more children a woman has, the more pronounced this stretching becomes.
During menopause, levels of the reproductive hormone estrogen decline rapidly. This leads to a noticeable decrease in breast volume, particularly in the upper half of the breasts. Estrogen levels are also tied to the production of collagen, a compound that keeps our skin strong and elastic. As collagen levels drop, women notice their skin becoming looser. The breasts are particularly affected by this change because their weight places a great deal of stress on the skin, causing it to stretch.
Weight Gain and Loss
Breasts contain a significant amount of fatty tissue. Most women, therefore, notice that their breasts become larger when they gain weight and smaller when they diet or exercise. Though the skin can generally accommodate normal fluctuations in weight, losing 30 or more pounds can result in permanent skin laxity.
Certain habits can cause the breasts to age prematurely. Engaging in high-intensity workouts (without first putting on a supportive, high-quality sports bra) can damage the skin and connective tissues within the breasts, causing them to sag. Smoking and inadequate use of sunscreen can also contribute to breast ptosis (both of these habits lead to collagen degradation).
How to Tell if You Need a Breast Lift
The decision to have breast lift surgery is an intensely personal one, so it should be guided primarily by your own feelings. If you’re content with the shape and size of your breasts, there’s no reason to change them. With that in mind, there are a few general guidelines you can use to gauge whether or not breast lift surgery might be right for you. Good candidates for breast lift surgery usually have breasts that are oblong in shape (not round), with downward-pointing nipples. However, this is not always the case; breasts with mild ptosis may not display these characteristics. Many experts, therefore, recommend trying the “pencil test” before you book a breast lift consultation: Put a pencil in the space just under your breast, allowing the breast to fold over it so that it remains in place. Then, raise your arms. If the pencil stays firmly where it is, you probably have some degree of breast “droop.”
Breast Lift Surgery Explained
Breast lift surgery, by itself, will not add any volume to your breasts. Most patients report that their breasts are slightly smaller after they have this surgery, owing to the removal of excess skin. This procedure is used solely to improve the shape and elevation of the breasts. However, if you also wish to have fuller breasts, you should ask Dr. Singer about combined lift-augmentation surgery when you visit him for a consultation. During lift-augmentation surgery, breast implants are inserted into the breasts, then any remaining loose skin is removed and the breast shape improved. Combining both of these operations (mastopexy and breast augmentation surgery) into one procedure saves the patient time and money and repeated anesthesias.
There are currently four different breast lift techniques in use: The crescent lift, the peri-areolar lift, the vertical lift, and the anchor lift. These techniques are designed to treat different degrees of breast ptosis while avoiding any unnecessary scarring.
The Crescent Lift
The crescent lift is the least invasive form of mastopexy. During a crescent lift, just one incision is made along the upper portion of each areola. Excess skin is removed from the top half of the breast, then the areola is positioned slightly higher on the breast. Although how any particular patient heals is individual, in most patients the small scar that results from this operation is almost completely camouflaged by the lighter ring of tissue that surrounds the areola.
This breast lift technique is usually recommended for women who have small breasts with a limited degree of ptosis. It’s also frequently used during combined lift-augmentation surgery. Because breast implants occupy some of the patient’s excess skin and produce favorable changes in breast shape, less lifting is required during lift-augmentation surgery.
The Peri-Areolar Lift
The peri-areolar (or “donut”) lift is similar to the crescent lift, with one key difference: Incisions are extended around the entire circumference of the areola during a peri-areolar lift. This both allows for the removal of more excess skin and permits Dr. Singer to make substantial changes to the areola. This technique is therefore well suited to patients who have mild to moderate sagging, but who desire smaller or higher areolas. This type of lift can also be adapted to reduce nipple projection. Like the crescent lift, the donut lift usually produces little visible scarring.
The Vertical Lift
The vertical lift, sometimes also called the “lollipop” lift, is used to treat moderate to moderately severe breast ptosis. This mastopexy method gets its nickname from the lollipop pattern of incisions used during this procedure: On each breast, an incision is made both around the nipple and down the underside of the breast. The addition of a second incision allows Dr. Singer to remove a larger portion of excess skin from the underside of the breast.
The Anchor Lift
The anchor lift is is usually reserved for women with large breasts who are experiencing severe ptosis. This technique requires the creation of three incisions in each breast: One around the areola, one down the underside of the breast, and one along the fold beneath the breast. This method can be used to substantially alter the shape of the patient’s breasts, making them much rounder while moving the areola higher.
To figure out which breast lift technique is right for you, you’ll need to arrange a personal consultation with Dr. Singer. In general, however, larger-breasted patients and patients who used to be heavily overweight benefit the most from vertical and anchor lifts.
What to Expect During Breast Lift Recovery
The duration of the recovery period needed after having a breast lift varies, depending on the patient’s age and the type of surgery she had. A younger patient who has undergone the least invasive form of mastopexy (the crescent lift) can expect to spend about seven days recuperating. A mature patient who has undergone an anchor lift, on the other hand, may need to spend two to three weeks resting.
While you’re healing, you’ll need to wear a special compression garment, which will be provided to you by Dr. Singer. This garment is used to minimize swelling and accelerate the healing process. To avoid experiencing soreness, you’ll have to take prescribed pain medication for at least three to five days after your surgery. Make sure you take this medication on schedule, rather than waiting for pain symptoms to flare up before you take your first dose. Pain is usually more difficult to treat after it’s started than it is to prevent.
Finally, you’ll need to avoid most forms of exercise for three to four weeks after your operation, the length depending on the extent of the procedure.. After week three, you may be cleared to engage in specific low-impact activities. However, you can expect to wait fully six weeks before you’ll be able to resume high-impact activities, like playing sports.
When is the Best Time to Have a Breast Lift?
Timing your breast lift properly is important. Ideally, you should wait until you’re completely done having children before having a mastopexy. We recommend taking this approach because subsequent pregnancies will create more loose skin, compromising the results of your procedure. Likewise, breast lift surgery can sometimes interfere with a woman’s ability to breastfeed.
Before having breast lift surgery, you should also make sure you’re within 10 pounds of your ideal weight. Maintaining a stable weight is the best way to prevent fluctuations in breast size that might otherwise interfere with your breast lift results.
Schedule a Breast Lift Consultation in La Jolla
Plastic surgery is the only way to permanently alter the shape of breasts that have become flat and droopy. Other interventions, like exercise and non-surgical topical treatments, which are promoted on social media and other marketing venues have been proven ineffective when it comes to treating breast ptosis. Though exercise has numerous health benefits, it cannot tighten loose skin. If the shape of your breasts is making you feel self-conscious and taking a toll on your self-esteem, the path to healing starts with arranging a mastopexy consultation. Contact Dr. Singer today to learn more about how breast lift surgery can improve your appearance and your confidence.