ideal size and shape of the human breast is a matter of personal
and cultural preference. It also varies with the dictates
Premature sagging occurs as a result of stretching the Cooper's
ligaments that help suspend and support the breast. Breast
ptosis (drooping breasts) can result from a loosening of the
skin and suspensory ligaments. Gravity and weight of breasts
take their toll over time. Ptosis can also come from a reduction
in the volume of breast tissue. This can occur after pregnancy
and weight loss.
Although good breast care primarily means keeping your breasts
healthy, for some women it also means keeping your breasts
smooth and firm. There are two reasons for breast to sag:
large breasts and age. Somewhere between the age of 30 and
40, the elastic tissue in the breast begins to degenerate.
The breast fibres, which act like rubber bands and provide
that resilient bounce as you walk, will still stretch, but
they don't snap back quite as well. The result is saggy breasts.
Adding to the problem, hormonal changes - both during pregnancy
and as you reach menopause - make breasts sag even more.
Three types of aesthetic procedures are commonly performed
on the breast as under:
augmentation (making the breast larger)
Mastopexy (lifting up the sagging breast)
Mammaplasty (Breast augmentation)
Breast augmentation (also called mammaplasty) is a surgery
to contour and enlarge breasts using implants. Many women
choose the procedure because they feel their breasts are too
small for their body. Some women lose breast size after childbirth
or breastfeeding. For others, nature was not overly generous
to begin with. And there are other women who are bothered
by uneven breasts and would like a more naturally balanced
It is done by placing an implant (also called a prosthesis),
either directly behind the tissue of the breast gland or underneath
the pectoral muscles as well as the breast. Many designs of
implant are used. They all consist of a silicone bag containing
a fluid. The outside of the silicone bag or envelope is sometimes
textured. The first fluid used to fill implants was silicone
gel, followed by saline (salt water).
The breast implant is inserted through either an incision
around the lower border of the nipple (at the edge of the
areola or pigmented area), an incision in the skin fold below
the breast or an incision in the armpit. Choice of incision
and breast size is largely a matter of preference of the patient
and plastic surgeon.
Mastopexy (Breast Lift)
Breast lift (or mastopexy) is a surgical procedure to reshape
and raise sagging breasts. The surgeon removes excess, stretched
skin, which has allowed the breasts to droop, and lifts the
nipples to a higher, more pert position. If desired, the size
of the areola can be reduced as part of the procedure as well.
In some cases, breast implants are inserted at the same time
to round and shape the breasts for a fuller, more natural
appearance. A breast lift is similar to breast reduction mammaplasty
- both procedures remodel the breast. The breast lift reshapes
the breast by the removal of stretched and sagging skin; the
breast reduction removes fat and breast tissue as well.
There are several techniques for a breast lift that the cosmetic
plastic surgeon can consider depending upon the degree of
droopiness (ptosis) of the breast. In a youthful breast, the
nipple lies above the inframammary fold on the mound of the
breast. The surgeon will examine your breast, decide on the
degree of ptosis, and then determine the surgical treatment
best for you.
Reduction mammaplasty (breast reduction) is the surgical reduction
of the breast tissue, and re-tailoring of the overlying skin.
This operation involve cutting around the nipple, leaving
it attached to the chest wall by a stalk of breast tissue,
removing excess skin (and glandular tissue in a reduction)
and closing the re-shaped breast.