Breast uplift surgery restores drooping breasts to a more youthful perkier shape.
7 July 2014| Last updated on 30 January 2018
Breast drooping or sagging, known medically as ptosis, can result from any one, or more likely a combination, of several possible factors. Ageing, pregnancy, breastfeeding, smoking and weight loss all take their toll, and particularly the stretching of the tissues due to breast enlargement during pregnancy, with multiple pregnancies having a more pronounced effect. Breast ptosis is also influenced by heredity, which determines a woman's skin elasticity, breast size, and the balance of adipose (fatty) and glandular tissue.
Some women still mistakenly believe that ptosis comes about because the breasts themselves provide insufficient support, and that sagging can be prevented by the regular wearing of a bra. However there have been numerous studies disproving this. We spoke to Dr Allen Rezai, lead Consultant Plastic and Reconstructive Surgeon at Elite Plastic & Cosmetic Surgery Group in Dubai Healthcare City and specialist breast surgeon who confirmed that "there is no medical evidence that wearing a bra can prevent breasts sagging. The breast itself is not muscle so keeping it toned up is impossible. Women's breasts begin to droop with age and extremely large-breasted women are generally more seriously affected. However, sagging has only very little to do with the ligaments. It is more a function of the weight of the breasts and skin elasticity."
The severity of breast sagging is categorised by evaluating the position of the nipple relative to the fold beneath the breast, known as the infra-mammary fold, the point at which the underside of the breast attaches to the chest wall. Dr Rezai explains that “plastic surgeons describe the degree of breast sagging using a ptosis scale, such as the Regnault ptosis scale in which Grade I represents Mild Ptosis with the nipple at the level of the infra-mammary fold and above most of the lower breast tissue. Grade II represents Moderate Ptosis, with the nipple located below the infra-mammary fold but higher than most of the breast tissue. Grade III is Advanced Ptosis, where the nipple is below the infra-mammary fold and at the level of maximum breast projection. Grade IV represents Severe Ptosis, and here the nipple is far below the infra-mammary fold, pointing downwards. There are also two other conditions that are taken into account. The first is referred to as Pseudoptosis in which the nipple is located either at or above the infra-mammary fold whilst the lower half of the breast sags below the fold. This is most often seen when a woman stops nursing. And then there is the condition of Parenchymal Maldistribution in which the lower breast tissue is lacking fullness, the infra-mammary fold is very high, and the nipple and areola are quite close to the fold. This latter condition is usually a developmental deformity and is seen in conditions such as a tuberous breast.”
To correct drooping breasts and return them to a youthful look, essentially two options are available: firstly the surgical procedure of Breast Uplift alone, known medically as Mastopexy. And then there is the procedure of Breast Uplift combined with implants, known medically as Augmented Mastopexy. According to Dr Rezai, the assessment of ptosis using the Regnault classification scheme provides some useful guidance in determining whether or not the patient requires a combined procedure, and if so, which approach should be used. Minor degrees of ptosis can be adequately corrected by breast augmentation alone using implants. However, once the ptosis has reached a point where the nipple is at or below the level of the breast crease, an Uplift procedure is the only way to restore the youthful high nipple position.
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Breast uplift will involve a certain amount of scarring. Dr Rezai explains that “The extent of incision required depends on the droopiness of the breasts and is determined by the amount of skin to be removed and how much the nipple must be raised. These scars may be restricted to the area around the nipple, when using what is known as the circumareolar or donut incision, extend down towards the breast crease, when using the lollipop incision, or also continue along the breast crease, when the anchor incision is employed. In my practice I make every effort to use limited incisions hence minimise scarring while achieving an aesthetically pleasing breast shape.”
When considering who might be a good candidate for Breast Uplift surgery, Dr Rezai explains that “women whose breasts are pendulous but satisfactory in size, or whose breasts lack substance and firmness, or whose nipples and areolae point downwards, particularly if they are positioned below the breast crease, or if the tissue surrounding the nipple or areola has become stretched. Indeed any of these circumstances either alone or in combination can indicate that someone is a suitable candidate for Breast Uplift. Sometimes these conditions may be inherited traits. In certain cases the breasts may have developed differently so that one breast is firm and well-positioned while the other is not. There may also be differences in the size of the breasts as well as their shape,” says Dr Rezai, who adds that “there are many women who feel restricted by the way that their sagging breasts interfere with their confidence to choose certain items of fashionable clothing, and women whose self-esteem, social confidence or relationships are affected by concerns about the appearance of their breasts. These are all reasons why some women might consider breast surgery of one type or another.”
According to Dr Rezai, the procedure for Breast Uplift, with or without implants, will be carried out under a general anaesthetic and will take from 60 to 90 minutes. The majority of patients stay in hospital overnight. A return to normal physical activity can be expected within 2 weeks, however exercise should only be resumed after 4 to 6 weeks. There are also various surgical options that depend upon the wishes of the patient, technical considerations and also the preferences of the surgeon. These will all be discussed in detail prior to the operation at consultation with the surgeon.
Dr Rezai further explains that “following the operation, as the healing process is gradual, patients should expect to wait at least several weeks to get an accurate picture of the results of their surgery. Incisions will fade over a number of months until they become barely visible, although it is important to remember that no surgical scar will ever totally disappear. For most women, the results of their surgery will last for very many years. Although there are certain factors that may reduce this period, including having larger, heavier breasts that tend to sag again somewhat earlier. Also when larger size implants are selected. Or in women who gain significant amounts of weight following surgery. Also women who later become pregnant may develop significantly larger breasts that again sag,” says Dr Rezai.
For more information concerning Breast Uplift surgery, breast implants and the options available, and also other types of plastic and aesthetic surgery offered by Elite Plastic & Cosmetic Surgery Group or to book a Consultation please visit our website or call +971 4 431 2396.