There are many patients who are unhappy with the droopiness of their breasts. This can occur in a younger lady who has large breasts who loses volume or, more commonly, in patients after pregnancy who have developed large breasts whilst breastfeeding their children. After breastfeeding ends, they are left with droopy breasts.
Choosing the right method to improve the droopiness of the breast is largely determined by the degree of droopiness or ptosis and whether the patient wishes to have a larger breast volume. A good method for lay people to assess droopiness is to look at the position of one’s nipples relative to the midpoint of the arm between the shoulder tip and the elbow. In a normal breast, the nipple should be at the midpoint. In moderate ptosis, it is up to 3 cm below the midpoint. In severe ptosis, it is more than 3 cm.
1. Breast Augmentation to Improve Droopiness
In patients with moderate droopiness who can accept an increase in breast volume, we favour using breast augmentation to improve their breasts. This is because this procedure has less scarring and downtime compared to the mastopexy. Augmentation, whether by fat grafting or implant, can usually be done as a day surgery under intravenous sedation or general anesthesia.
In smaller breasts, it is feasible to augment the breasts using fat grafting. The fat is harvested from a donor site which can be the abdomen, flanks or thighs. It is harvested using a low pressure system to keep the fat cells alive. The Lipokit uses a filter and centrifuge to concentrate the less mature fat cells in the aspirate. This improves the success rate of the procedure. The fat is then injected following a specific template into the breast. The incisions are small and the scarring is therefore minimal.
In larger augmentations, the success rate of fat grafting is less and so implant augmentation is the preferred method. In particular, a placement of a tall anatomical implant is effective for improving the droopy appearance of the breast. This can be done through relatively small incisions in the crease below the breast or through the edge of the areola. The scarring is therefore moderate when compared to a mastopexy.
2. Mastopexy to Improve Droopiness
In patients with pronounced droopiness of the breast, the mastopexy or breast lift is the surgery of choice. It is a method that can correct the most severe of cases and can also be done together with a removal of breast tissue. This is called a reduction mammoplasty. This is larger surgery with more pronounced scars. These can be around the nipple only, around the nipple with an extension downwards or shaped like a ship’s anchor. The surgery requires general anesthesia and a 3-4 day hospital stay. For this reason, we reserve this surgery only for the patients with the most droopy or largest breasts.
As the correction of droopiness is a complex problem which can be solved by many types of procedures, it is best to seek the advice of your Specialist Plastic Surgeon before embarking on any procedure.
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