Descriptions of Breast Ptosis or Sagginess

There are varying degrees of breast ptosis, or sagginess. As your breasts develop as a young woman they are typically perkier because the overlying skin has not been stretched from weight gain or pregnancy and the underlying supportive tissue has not been stretched. If you lose weight or stop breast feeding, many times the skin does not shrink back to its original shape leading to breast sagginess. This stretching or sagginess will determine if you need a lift or not. Some women need smaller lifts for correction, while other cases require a full lift or mastopexy. This description will cover the commonly described ptosis grades to help you better understand what you may need in terms of a breast lift. The best way to know is to meet with Dr. Edwards where you can verbalize your goals and then an examination will be performed to see just what your grade of ptosis is.

Your Degree of Ptosis

The first step is to locate your inframammary crease, which lies directly underneath the breasts. The easiest way is with a ruler, placing the highest edge directly against the junction of the breast and ribcage (see the lines on the photos below). It is important to look at eye level with the inframammary fold. If you have someone take photographs the camera should be at the level of the nipple.


If the central point of your nipple (not your areola) is slightly above the top of the ruler (the inframammary crease), you may have Grade 1 Ptosis and you will typically not require a breast lift with breast augmentation. If you choose a small implant and your tissues are thin and stretched, you may still benefit from a lift of some kind.

If the central point of your nipple is 1 – 3 cm below the top of the ruler, you have a Grade 2 Ptosis. If you were to have a breast augmentation when you have a Grade II Ptosis without any kind of breast lift, you risk a less than optimum result with resulting sagginess of the lower breast or the implant sitting lower on your chest.

If the central point of your nipple is more than 3 cm below the top of the ruler, you have Grade 3 ptosis and will require mastopexy with a breast augmentation. The areola size is reduced in breast lift procedures. This will result in a scar around the smaller areola, down the middle of the breast and possibly underneath in the fold of the breast.


Psuedoptosis occurs when your nipple is still above your inframammary crease but the breast still appears droopy due to the presence of breast skin and tissue hanging below.

Pseudoptosis often times requires some form of skin-tightening procedure to give the most optimum result. Even if you pass the ptosis “tests” above, you may still feel as though your breasts lie too low on your chest wall or that your areola have stretched out. Every woman is different and often times your breasts are different from each other.


Types of Breast Lifts

Around the Areola, OutlineAround the Areola, Incision

The Peri-areolar lift involves removing a doughnut-shaped piece of skin from around the areola (including some of the areola itself in areola reduction cases) to draw the breast together with a drawstring stitch. The edges are then sutured and may exhibit some puckering or pleating. This typically softens out over the next year of healing.

Vertically Down from the Areola, OutlineVertically Down from the Areola, Incision

The Vertical Lift will provide more lift in the saggier breast as well as a smaller areola. It does not require the scar in the fold of the breast.

Horizontally along the breast crease, outlineHorizontally along the breast crease, incision

The Anchor or Full Lift is the strongest lift that helps to remove excess lower breast skin and provides more lift with or without a breast implant. The goal is to hide the scars in creases as best possible.


This is a simple description that allows you to have some idea if you may need a lift with or without a breast implant. The best way to know will be to meet with Dr. Edwards and have a private unhurried consultation where your options can be discussed.

Dr. Edwards