Why Do Breasts Sag?

Breast sagging or droopiness—medically referred to as breast ptosis—develops naturally as the body changes and ages, with the descent of breast tissue presenting as a universal aesthetic concern for most women at some point in their lives. The gradual drooping of breasts can be caused by a combination of factors, including low collagen and elastin production, depleted breast volume, stretched breast skin, and a general loss of support for the breasts. This is due to genetic predisposition, aging, pregnancy, weight fluctuations, or some combination of all these factors. At any rate, the varying degrees of breast ptosis are usually divided into four categories:

  • Pseudoptosis: Known as the mildest case of breast sag, pseudoptosis is characterized by the lower breast falling slightly below the breast crease while the nipples remain above the inframammary fold.
  • Grade I: The extent of breast sag exhibited is still relatively mild, with the breasts resting below the breast crease and the nipples at the level of the inframammary fold.
  • Grade II: The breast tissue and nipples descend well below the breast crease, but the nipples are not yet at the lowest point in the breast.
  • Grade III: Referred to as advanced ptosis, the nipples often point downward and are positioned at the bottom of the breast.
  • Although “breast exercises” to strengthen the pectoral muscles have proven ineffective at treating breast sag, all four levels of ptosis can be corrected with a surgical breast lift or “mastopexy.” As a common treatment choice for women after they have undergone pregnancy and nursing, breast lift surgery is designed to reestablish support for descending breasts. Loose, excess skin is removed while the breasts are reshaped and raised to a higher, more youthful position on the chest wall. The nipples and areolas can also be resized and/or repositioned to achieve a natural-looking and youthful result. Dr. Ram Kalus and Dr. Craig Rowin perform breast lift surgery, with or without the addition of implants, at our Charleston practice for patients seeking a more rejuvenated breast contour with an enhanced rate of breast projection and proportions.

    If you are ready to book a consultation with our Charleston plastic surgeons, or if you have questions about how to resolve breast sagging, please contact our practice today.

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