Sagging breasts, what Plastic Surgeons call breast ptosis, can be quite a depressing condition causing poor self-confidence and low self-esteem, especially in younger women. It can just result from bad genetics and can happen to teenagers or can be a disappointing consequence of breast feeding one or multiple children or result from extensive weight loss.

Often it is difficult to advise women on the best procedure to correct their sagging breast problem as everyone will be able to accept a different result as a satisfactory outcome.

Often the problem is difficult to correct without placing scars on the breast, which are best avoided to result in an optimal aesthetic result. Unfortunately the more significant the breast ptosis (droop) the more scarring is required to achieve an optimal result.

There are two ways of addressing the breast skin redundancy that causes breast ptosis, one is to remove the redundant breast skin and maintain the existing breast parenchyma (gland) to lift and reshape the breast mound but not increase the breast volume. This procedure is called a mastopexy (breast lift). The second way is to maintain the existing breast skin envelope but increase the breast parenchymal volume by adding an implant or possibly fat. This can lead to a much improved breast shape and larger breast volume should that be thought desirable without any visible breast scarring. This is a breast augmentation procedure.

Also in some cases a combination of breast augmentation and breast lift can be incorporated together or at times in two separate procedures depending on the situation.

Ultimately it’s my advice that the best procedure is determined by what is seen as the most acceptable outcome.

If the existing breast size is wanted to be maintained and scars are not a concern, then a breast lift (mastopexy) procedure would be the best option to lift and reshape the breast mound. However if a larger breast volume was desirable and breast scars were best avoided for an optimal aesthetic result then a primary breast augmentation procedure maybe a better option, realising this may not give as much breast lift. It is important to understand that if a single procedure does not give an optimal result that the alternate procedure can usually be performed secondarily to improve the outcome. That would be either breast augmentation to follow a breast lift to improve volume or shape or breast lift to follow a breast augmentation if more breast lift is required. More recently fat transfer at the time of breast lift has proven of benefit to improve the breast shape and volume without the risks of a breast implant.

I have looked through my outcome photos of patients with similar degrees of breast ptosis having the two different treatment approaches, ie mastopexy or breast augmentation. Hopefully by comparing the outcomes will help you decide which procedure might achieve the outcome you desire.

I would suggest you study the information on the two procedures on the Bayside Plastic Surgery website and look at other patient outcomes. If you would like to discuss the situation more please contact Dr David Ross at Bayside Plastic Surgery on 03 9596 8888 to arrange an assessment and consultation.

This first patient is a 38 year old mother of three children with significant breast ptosis who decided to undergo primary breast augmentation to improve her breast shape. This was done using 460ml round saline breast implants inserted through the axilla. Her final breast size was a 14D.

The second patient is a 39 year old mother of three children with considerable breast ptosis who decided to undergo a mastopexy procedure where about 200g of breast tissue was removed from each side and the breasts reshaped and lifted. Her final breast size was 12C.

A third patient who decided to undergo a mastopexy procedure is a 26 year old woman to correct her significant breast ptosis as a result of weight loss. Her resultant breast size was 12C.

David A. Ross

Bayside Plastic Surgery January 2015