Ptosis means sagging. The amount of breast ptosis is graded depending on the location of the nipple with respect to the inframammary fold or IMF.

The IMF is the fold under the breast where the breast skin meets the chest.

Breast ptosis falls into one of three classes.

• Grade I Ptosis - The nipple is located above the IMF
• Grade II Ptosis - The nipple is located at or lower than the IMF but still points forward
• Grade III Ptosis - The nipple is located lower than the IMF and is pointing downward

Pseudoptosis - Literally fake sagging. The nipple is correctly positioned, but the breast tissue is below the IMF.

The higher the grade, the bigger the lift needed to restore a more ideal breast shape. Pseudoptosis will often respond to breast augmentation without a breast lift.

Whatever the used technique of Breast Lifts, there some common steps.

• The nipple and areola remain attached to the breast tissue. This preserves the nipple's sensation and blood supply.
• Large areolae are reduced and elevated on the breast mound by sliding the them under the breast skin to the correct level.
• Excess skin on the lower breast is removed to form a new skin brassiere that lifts the breast tissue higher on the chest wall.
• The location of the scars depends on where the skin is removed.
• The amount of elevation required, the starting position of the nipple/areola complex and the amount of excess skin all determine the best breast lift in each case.

1. Crescent Lift (Crescent Mastopexy): The crescent breast lift is named for the shape of the skin that is removed. A crescent is drawn on the skin, over the top of the areola. The crescent of skin is removed or de-epithelialized (when just the outer epithelium of the skin is removed), and the area is closed, lifting the nipple and areola. Since the areola is still attached along its lower half, the amount of lift is limited. Moreover, pulling too hard will distort the shape of the areola. Because of the limitation, the Crescent Lift is used for small adjustments to the nipple/areola position, and cannot be used to correct significant ptosis (sagging).
2. Periareolar Lift (Periareolar Mastopexy): The periareolar breast lift is named after the location of its scar, because the incision is made around the areola. The shape of the skin excised gives this lift its nickname - the doughnut lift. Since the lower aspect of the areola is closed downward, it tethers the areolae inferiorly and limits the amount of vertical lift to one or two centimeters. This type of purse-string lift is often performed in combination with breast augmentation in cases where there is borderline ptosis. It is also helpful for decreasing the overly full or puffy areola that is seen with the tubular breast deformity.
3. Vertical Lift (Vertical Mastopexy): The vertical breast lift is so named because it has a vertical scar added to a periareolar scar. The two shapes drawn together give the lift is nickname - the lollipop lift. The periareolar scar is a circle like the top of a lollipop, while the vertical scar runs straight down forming the stick. It is a variation on the inverted-t technique that eliminates the IMF scar. Since the lower aspect of the incision is closed side-to-side, there is no downward pull on the areolae as there is in the pure periareolar approach. The side-to-side closure pinches the lower pole of the breast and helps push the nipple-areolar complex higher up on the breast.
4. Inverted-T Lift, Anchor Lift, Keyhole Lift (Inverted-T Mastopexy, Anchor Mastopexy, Keyhole Mastopexy): The inverted-T breast lift gets its name from the inverted capital T shape of the scar that is at 6 o'clock on the periareolar scar. The anchor lift names arise because the overall shape of the scar looks a bit like an anchor. The keyhole nickname comes from the shape of the upper portion of the resection. It looks like a keyhole before is it closed. This is by far the most versatile breast lift as it can reshape even severely overstretched and deflated breasts.

• Breast Lift Recovery usually takes a few days to weeks.
• During the first few days, you will need to take it easy and just recover.
• Ice, elevation, rest and a comfortable bra will all help. An instruction sheet will be supplied for your post-operative care.
• Dr. Ahmed will see you back in the office periodically, beginning the week after your Breast Lift to be certain that you are healing well.
• Drains are not usually used, but in the rare cases when required, they are removed at the first follow-up visit. Walking is encouraged right after surgery.
• Desk work may resume as soon as you feel fit, often in a few days.
• Vigorous activities, that require repetitive overhead motion or that cause bouncing should be avoided for at least six weeks.
• Excess pain, swelling or other problems should be reported as soon as possible to keep everything on track. As you continue to heal, specific instructions for scar care will be detailed.

A breast lift is a surgical procedure that helps to reshape your breasts and changes the way they hang off your chest.

It is NOT a cure for gravity. And is NOT permanent.

Your breasts will begin to sag again after the surgery.

How long will a lift last?

That depends on how heavy your breasts are, how physically active you are, and how strong/supporting your tissues are.

Some women will drop significantly within months (but not to the same level as before) while other will take years before they re-develop significant sagging.

Although complications following Mastopexy are infrequent; the following may occur:

1. Bleeding, which in rare instances could require hospitalization and blood transfusion. Blood clots may form under the skin and require drainage.
2. Skin irregularities, lumpiness, hardness, and dimpling may result; some problems disappear with time and from massage, but skin irregularities, hardness, lumps, dimpling, or other problems, may persist and additional treatments may be necessary.
3. Infection is rare but may occur and treatment with antibiotics and /or drainage may be required. In rare instances surgery may be required for severe infection (ex: necrotizing fasciitis)
4. Wound dehiscence (wound opening) may occur and is generally allowed to heal on its own.
5. Outpatient nursing may be required to assist with the wound care. You may be required to travel to a local clinic for daily wound care.
6. Infection or loss of blood supply can lead to partial or complete nipple/areola loss, requiring potential reconstruction.
7. Numbness of the skin over treated areas is common and persists for months. In extremely rare cases it may be permanent.
8. Abnormal scarring or scar position is rare but is possible.

Am I a good candidate for a Surgery?
The best candidates are women who have all the information, fully understand what the surgery involves and its limitations, and who have a realistic expectation.

Besides fundamentally improving confidence, self-esteem and body image, common reasons for a Breast Lift alone are:

1. Breasts that are pendulous, but of satisfactory size
2. Breasts that lack substance or firmness
3. Nipple/areola complexes that point downward (especially if they are positioned below the breast fold)
4. Asymmetry between the two breasts and/or nipple/areola complexes

Is there an upper age limit for surgery?
Health is the important factor, not age.

Any woman, may be a good candidate for a Breast Lift providing she is healthy, in good physical shape, and understands the risks associated with a Breast Lift procedure.

When should I have a Mastopexy after pregnancy?
After pregnancy and breastfeeding, your breasts will either revert to their pre-pregnancy state or possibly leave you with a deflated and sagging appearance.

It normally takes about 3 months for these changes to happen, and for that reason you should wait and not rush into surgery too early.

You wait until your breasts have stabilized (until they are not changing any longer) before planning your surgery.

Will a Mastopexy correct asymmetry?
Yes, improvements to breast asymmetry are always addressed during Breast Lift (Mastopexy) surgery.

Please note that perfect symmetry is not natural and achievable.

In some cases, breast implants may be recommended.