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.

Breast Lifts alone do not add volume to the breast.

This is especially apparent in the upper aspects of the chest.

A breast lift can move the nipple up the breast and the breast mound off the abdomen and back into the chest, but Mastopexy alone does not fill the upper chest.

Even patients with large breasts before having a breast lift, may still have relatively little or no upper pole breast tissue.

This is seen even with Breast Reduction patients, who have an excess of breast tissue.

A breast lift is performed as part of the breast reduction.

While breast mound and nipple are lifted, in most cases the volume of the upper breasts cannot be significantly enhanced without using a breast implant.

Because the two operations, Breast Augmentation and Breast Lift, are complimentary, a beautiful synergy can be achieved with the combination procedure of Breast Augmentation Mastopexy.

It is also one of the most complex cosmetic plastic surgery procedures, and it takes years of experience to develop reliable techniques that safely and reliably combine breast augmentation and breast lift.

Because of the complexity, some plastic surgeons prefer to perform the procedure as two separate operations, but with careful planning, a Mastopexy that includes breast implants can be performed safely and effectively as a single operation in many cases.

The most common indications for combining breast augmentation with a beast lift are listed here:

• After pregnancy, child birth and breast feeding
• After weight loss, especially massive weight loss or after bariatric surgery
• Breast ptosis (sagging) combined with a desire to increase cup size
• Breast ptosis (sagging) combined with a desire to increase fullness in the upper breast
• Breast enlargement when the nipple is low on the breast

Breast augmentation can be combined with any of the common breast lifts. A short review is provided here, and more details on breast lifts can be found on the breast lift Mastopexy.

Breast lifts are listed in ascending order from Mastopexy which provide the shortest scar (and the smallest amount of lift) to the largest.

The Common Types of Breast Lifts

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.
• Plus breast Augmentation either under or over pectoralis muscle.

1. Crescent Lift (Crescent Mastopexy
2. Periareolar Lift (Periareolar Mastopexy
3. Vertical Lift (Vertical Mastopexy
4. Inverted-T Lift, Anchor Lift, Keyhole Lift (Inverted-T Mastopexy, Anchor Mastopexy, Keyhole Mastopexy)

• 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:

• Bleeding, which in rare instances could require hospitalization and blood transfusion. Blood clots may form under the skin and require drainage.
• 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.
• 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)
• Wound dehiscence (wound opening) may occur and is generally allowed to heal on its own.
• 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.
• Infection or loss of blood supply can lead to partial or complete nipple/areola loss, requiring potential reconstruction.
• Numbness of the skin over treated areas is common and persists for months. In extremely rare cases it may be permanent.
• Abnormal scarring or scar position is rare but is possible.