Indiana Plastic Surgery Blog

Ptosis (pronounced “toe-sis”) is a condition characterized by breast droop and loose, stretched skin on the breasts.  The skin on a woman’s breasts is primarily responsible for maintaining their position.  When the skin becomes stretched or loose or less elastic, the breasts will droop.

What causes breast ptosis?

Breast ptosis is caused by a combination of factors including large breast size, aging, and gravity.  Large breasts may be gradually pulled down by gravity and the skin becomes thinner and less elastic with age.

A recent study sheds light on the lifestyle factors that contribute to breast ptosis.  Plastic surgeons at the University of Kentucky found that age, significant weight loss, higher BMI, larger bra cup size, number of pregnancies, and smoking were found to be significant risk factors for breast ptosis, while “breast-feeding, weight gain during pregnancy, and lack of participation in regular upper body exercise were not found to be significant risk factors.”

Evaluating Breast Ptosis

Plastic surgeons often measure breast ptosis using the Regnault classification, which is as follows in simplified form:

1. Pseudoptosis – the nipple falls above the fold, but the breast is hypoplastic and hangs below the breast crease.

2. Glandular Ptosis – the nipple is above the fold, but the breast hangs below the crease.

3. Minor Ptosis – the nipple is level with the breast crease.

4. Moderate Ptosis – the nipple is below the breast crease, but above the lower breast contour.

5. Severe Ptosis: the nipple is below the breast crease and below the lower breast contour.

Correcting Breast Ptosis

Using the classification system above, a surgeon can recommend the right procedure to correct breast ptosis.  Surgery to correct minor ptosis may be quite different from the procedure to correct a severe case of ptosis.  The usual procedure of choice is breast lift surgery / mastopexy.

Revisionary breast procedures may include breast implant removal, a change in size, or a switch from saline to silicone.

During such procedures, some patients may benefit from a breast lift, when down sizing or after weight changes.  Over time, skin loses its elasticity, which requires excess skin to be removed and/or tightened.  The amount and degree are determined by the patient’s desired breast size and the amount of elasticity remaining in your skin.

Site location, above or below the muscle, as well as the type of implant (saline or silicone) will also determine the appropriate procedure and your final result.  In some circumstances, patients may not need a lift and instead may benefit from a site change.