Mastopexy or Breast Lift with Augmentation

Grade 1 Ptosis  Grade 2 Ptosis  Grade 3 Ptosis   Psuedoptosis    Double bubble

In cases were the breast is droopy or sagging. A lift may be needed. The extent of the scar will depend on your anatomy and the degree of ptosis (droopiness) present. Some women have this condition naturally whereas many won't experience it, if at all, until after pregnancy or weight gain and loss. When a lift is performed it is called a mastopexy.

Ptosis is categorized by the relationship that the nipple has to the inframammary crease (the crease at the bottom part of the breast). Depending on were the nipple relates to this crease is how we categorize the severity of the ptosis (droopiness).

Grade 1 Ptosis is when the nipple is directly in front of the crease.

Grade 2 Ptosis is when the nipple falls 1 to 2 centimeters below the breast crease.

Grade 3 Ptosis is when the nipple is pointing straight down to the floor.

Psuedoptosis is when the nipple is at the level of the crease but the breast seems to have great deal of sagginess in the lower part of the gland.

Mastopexy usually takes one and a half to two hours. Techniques vary, but the most common procedure involves an anchor-shaped incision following the natural contour of the breast. Sometimes, if the anatomy is correct the scar can be limited to include the areola and a small vertical incision only, eliminating the bottom scar. This is called the vertical breast lift.

The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola are moved to the higher position.

Depending on the severity of the ptosis, is what will determine what surgical procedure is needed.

In grade 1 ptosis is when perhaps just the implants will be enough to lift the breast.

In grade 2 ptosis the sagginess is more severe and sometimes we will need an actual lift which may require a limited scar lift such as a circumareolar (around the areola) lift or even a vertical scar lift.

In grade 3 ptosis the severest of all, you may be able to do vertical scar lift and more often the anchor shaped lift.

In pseudoptosis the procedure selection will depend on the size of the breast, and the amount of droopiness. More than likely it will require some partial excision or removal of the inferior part of the gland since this is were the problems lies.

Ptosis correction can be done with or without implants, if the patient desires larger breast then an implant will be needed. If sagging is present and a woman opts not to have a lift, implants are typically placed above the muscle to fill out the breast skin and tissue. Submuscular placement could result in a "double bubble or snoopy deformity" effect. In these cases, the implant appears to be high on the chest, whereas the natural breast tissue hanging down over the implant giving it the appearance or having a separate breast.

Double bubble is the non-clinical terminology for when a woman with sagging breasts naturally, also has breast implants. When women with sagging breasts have a breast augmentation, a mastopexy (or lift) may also be advisable to lift as well as augment the breast. An alternative to the lift, which in many cases can cause unacceptable scarring, is to place a larger implant above the muscle to fill out the sagging skin and tissue. In such cases, the entire breast may be slightly saggy but will appear filled out.

If the breast implant is placed in the submuscular position in a woman with sagging, it is possible that the implant, which is placed high on the chest under the pectoralis muscle, will look separate from the breast tissue which hangs below it. For this reason, many women who desire submuscular placement will opt for a lift to avoid the double bubble or snoopy deformity.

This condition can also occur in women after they have had breast implants for a while if the breast tissue sags (such as after pregnancy) and the implant remains high on the chest.

Double Bubble or Snoopy Deformity	After a Mastopexy or Breast Lift