Breast sagging or ptosis is usually treated surgically by removing excess skin resulting in a firmer breast. Because the problem is related to the skin and breast tissue (fat, breast gland and suspensory ligaments) rather than muscle this problem is unaffected by exercise. The cause of drooping is multifactorial:

1. * breast size
2. * genetic predisposition
3. * smoking history
4. * bra use history
5. * gravity
6. * age
7. * weight loss
8. * pregnancy with breast enlargement-engorgement and breast feeding

Whether a lift should be performed or not and what type of technique is used is dependent on the degree of drooping not the size of the breast. The nipple should be in line with or above the level of the infra-breast skin crease i.e. while standing upright the nipple should lie 20cm (about 8 inches) diagonally from the notch of the upper edge of the breast bone. If the nipple lies only 2cm from the desired point a ring or donut of skin can be removed around the nipple areola complex thereby providing some lift with minimally visible scarring. For greater lengths of nipple elevation a lollipop or vertical incision is required. For even greater lengths where the nipples point downward toward the floor an inverted T or anchor shaped excision of skin is required.

For a natural look it is important to not make the skin pattern symmetric or mirror imaged across a vertical plane through the nipple. This patient required a significant amount of lifting as is evident in the oblique view which shows the nipple was far below the infra-breast skin crease. Therefore an invert T or anchor pattern skin excision was used to raise it up to the infra-breast skin crease level. The incision pattern is designed so that the scar is hidden under the breast when standing upright.

45 years old, 5'2" tall, 125 lb., 38C bra size, key hole pattern lift

Read Dr. Stone's blog about breast lift mastopexy surgery
• Breast lift mastopexy surgery Los Angeles

Breast lift surgery can enhance your appearance and your self confidence. Realistic expectations are important to be happy with any surgery. As each patient is an individual, different results can be expected in each patient.