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No matter how people feel about the relative size of breasts, the ideal of breast aesthetics is almost uniformly that the nipples are located above the inframammary fold and point directly forward or are slightly upturned. Breasts that do not meet this standard are described as sagging or, in medical terms, "ptotic." Ptosis is classified in three grades:
· Grade 1 ptosis is when the nipple is just below the inframammary fold
· Grade 2 ptosis in when the nipple is well below the inframammary fold, but still above the bottom of the breast
· Grade 3 ptosis is when the nipple is at the bottom of the breast, often facing down.
In addition, pseudoptosis is when the breast is flattened and droopy, although the nipple may not be out of position. The correction for ptosis and psuedoptosis is known as a mastopexy or breast lift. You are a good candidate for a breast lift if you have any degree of ptosis that you would like to have corrected.
There are several variants on the breast lift procedure that can be classed depending on the amount of lift they are able to give.
Crescent Lift
In the crescent lift, a small crescent of skin is cut from above the areola. The breast is reshaped around the missing skin, resulting in less ptosis and higher nipple position.
Doughnut Technique
In the doughnut lift, a circle of skin is cut from around the nipple. Then the breast is reshaped around the missing skin, resulting in less ptosis and higher nipple position.
Vertical Incision
The vertical incision involves the cutting of a tapered vertical segment of skin from above and below the nipple. When the breast is brought together, the scarring is relatively minimal, but a good level of lift is achieved.
T-Incision or Anchor Technique
The T-incision achieves the greatest lift, but also requires the removal of the largest amount of skin and leaves the largest scars. In this technique, an anchor shape of skin is cut from above and around the nipple, all the way down to the bottom of the breast along the inframmamary fold. When the skin is removed and the breast is reshaped, sometimes as much as 8 cm of nipple elevation can be gained.
Breast Tissue Variables
If you have an insufficient amount of breast tissue, a breast lift can be combined with a breast augmentation surgery. If you have a surplus of breast tissue, excess can be removed as part of a breast reduction. If you require a large amount of breast tissue be removed, it is possible your breast reduction can be considered medically necessary and may be covered or partially covered by your medical insurance.
If you require neither augmentation nor reduction as part of your breast lift, you may wish to take advantage of a new variation of breast lift that promises to give longer-lasting results than traditional breast lifts. Recently, some physicians have sought to extend the results of a breast lift by incorporating an artificial mesh into the breast tissue. However, the mesh has been shown to cause a higher incidence of complications such as infections and can complicate later procedures. Instead, doctors have turned to utilizing some of the chest muscle to provide additional support to the breast tissue, thereby increasing the projected lifespan of a breast lift.
Known as the Brazilian mastopexy, the procedure is, as yet, practiced by only a small number of cosmetic surgeons, and its long-term effectiveness is as yet untested, although it seems likely to be a major innovation.
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