Breast Uplift surgery is the solution to sagging and uneven breasts, decreased breast volume, drooping nipples and stretched areolae, recreating a youthful shape and lift to your breasts. If there is also too little breast volume, a Breast Augmentation using implants might also be recommended in addition to Uplift. Every year, many thousands of women undergo successful Breast Uplift surgery, experience no major problems and are pleased with the results.
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 enlarged breasts 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. Dr Allen Rezai, Consultant Plastic and Reconstructive Surgeon of Harley Street, London, and also founder of Elite Plastic & Cosmetic Surgery Group in Dubai Healthcare City, UAE, 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 Degree of Breast Ptosis
The severity of breast ptosis is determined by evaluating the position of the nipple relative to the infra-mammary fold (the point at which the underside of the breasts attach to the chest wall). In the most advanced stage, the nipples are below the fold and point towards the ground.
As with most surgical procedures, there are many options, depending upon the patient’s wishes, technical considerations. In breast uplift surgery, the primary focus is to correct the breast ptosis by removing excess skin and repositioning the nipple-areola hence altering breast volume and contour.
There are several techniques available to correct sagging breast, the technique is selected based on the degree of the breast ptosis. 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.
Plastic surgeons use the Renault Classification to determine the degree of ptosis.
Type I is Mild ptosis – The nipple areola is situated at the level of the infra-mammary fold and above most of the lower breast tissue.
Type II is Moderate ptosis – The nipple areola is situated below the infra-mammary fold but higher than most of the breast tissue.
Type III is Severe ptosis – The nipple areola is situated below or well below the infra-mammary fold and at the level of maximum breast projection. Sometimes the nipple even points downwards.
Pseudoptosis – Is not a true ptosis as the nipple areola sits either at or above the infra-mammary fold but the lower half of the breast sags below the fold. This is most often seen when a woman stops nursing.
Parenchymal Maldistribution – This involves a lack of fullness in the lower portion of the breast, a high infra-mammary fold and a relatively short distance from the fold to the nipple areola. This condition is usually a developmental deformity and is also known as tuberous breast.
Surgical Options for correction of Sagging Breast
The common surgical options for correction of ptosis are:
Breast Augmentation – This option is suitable for women with Type I, mild ptosis or those that have pseudoptosis (the condition in which the nipple is located either at or above the infra-mammary fold, and the lower half of the breast sags below the fold). In these patients, minimal elevation of the nipple areola is required.
Breast Uplift using Peri-areolar incision technique –The peri-areolar technique involves a crescentic excision and lift of the nipple areola. It produces the shortest possible scar and is well hidden within the nipple areola. This option is again best suited for women with type I, minor degree of ptosis requiring minimal elevation of the nipple areola.
Breast Uplift using Circum-areolar incision also known as the “Benelli” technique – The circum-areolar technique involves an incision around the areolar, and is best suited to correct mild to moderate ptosis where the nipple areolar requires minimal to no elevation. This technique is also used to reduce the size of the areola in Areola reduction and Tubular correction surgeries.
Breast Uplift using the “Keyhole” or “Lollipop” incision technique – The Keyhole / Lollipop uplift is required to correct moderate to severe breast ptosis, such as types II & III, where the nipple is below the level of the infra-mammary crease. This technique involves an incision around the nipple areola and vertical running from the areola to the infra-mammary crease.
Breast Uplift using the Inverted T or Anchor incision technique – The inverted T technique is required for patients with significant ptosis, very full lower breast poles, or those who require a long transposition of the nipple areola. In this method a keyhole incision is made around the nipple areola and vertical, running from the areola to the breast crease then continuing horizontally along the crease.
Breast implants can be used at the same time as the uplift to augment the breasts as well as lifting and reshaping them.
The Importance of a thorough Consultation
The importance of the initial consultation cannot be overemphasised. Evaluation of anatomic features and determining the degree of breast ptosis is essential when planning breast uplift surgery as it will indicate which technique is best suited to achieve the optimal result.
At your consultation, Dr Rezai will fully discuss every aspect of your aesthetic goals and address any concerns you may have; he places the utmost importance on providing his patients with all the information they need to make fully informed decisions, ensuring each one arrives at the outcome that’s best for them.
Your medical history will be discussed with you. It is important that you answer all questions as honestly and accurately as possible as failure to do so can have significant clinical repercussion.
A relevant physical examination will also be performed and various anatomical measurements will be taken to determine the level of ptosis (sagging) and to form the basis for the type of surgical technique required to achieve the best possible results. Breast volume is also an important consideration when planning an uplift procedure, sometimes, when enough breast tissue is not present to achieve an aesthetically pleasing appearance or you simply wish to increase the volume of your breast as well as reshaping them, breast implants may be used in conjunction with uplift.
Working together during your consultation, a bespoke surgical plan will be developed for you. Dr Rezai will explain in detail the treatment options available, the techniques that would be used, and any potential risks and complications you need to be made aware of. Dr Rezai will use his expertise and experience to guide you towards the best option, taking into account your anatomy, aesthetic goals and personal circumstances.
For more information about Breast Uplift surgery, breast implants and the options available, and also other types of breast surgery offered by Elite Plastic & Cosmetic Surgery Group or to book a Consultation with Dr Allen Rezai please visit Elite Plastic & Cosmetic Surgery Group’s website
or call +971 4 431 2396.