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Breast Sagging - Ptosis

How do I know that my breasts sag?

Although this question might seem moot, it is a question that I frequently get asked by women, because doctors and the general public define breast sagging and Ptosis differently. Some women think of their breasts as sagging if they have to wear a bra to hold them up! On the other hand, there are many women who feel that some degree of sagging is actually normal and natural. Unlike the public, the medical establishment defines breast sagging mostly based on the position of the nipple and its relationship to the breast mount. Instead, I find most women define sagging based not on the position of the nipples but on the extent of breast tissue descent on the chest wall.
Therefore to answer the questions that "are my breasts sagging", I recommend the following tests:

The Pencil Test
Place a pencil under the breast under-fold and if your breasts hold the pencil, then you have sagging.

The Bra Test
Do you need a bra to keep your breasts up on your chest? Do your breasts fall when you remove your bra? If your answer is yes, then your breasts sag.

Please note that these tests are not very reliable, because you can have breast tissue that is held up well, while the nipples are pointing to the floor! Therefore, the cosmetic surgeons define and classify the degree of breast Ptosis as followed;

Degrees of Breast Ptosis or Sagging.

Ptosis is a sagging condition where the breast both falls on the chest, and points downward. Cosmetic surgeons determine the degree of Ptosis according to the position of the nipple relative to that of the inframammary fold – the fold under the breast. Officially, a young breast that is not sagging is defined as one where the nipple sits above the level of the Inframammary fold, where the bra wire goes.

The following are the degrees of ptosis that your cosmetic surgeon will considering in determining your need for a Breast Lift:

Grade I- Minor Ptosis
Nipple is at the level of the Inframammary fold.

Grade II- Moderate Ptosis
Nipples have dropped below the level of the breast crease, but still higher that the majority of he breast mount.

Grade III- Advanced Ptosis
Nipples have dropped below the level of the Inframammary fold, and just at the level of maximum breast projection.

Grade IV- Severe Ptosis
Nipples have dropped below the level of the Inframammary fold, and below the breast mount. They are pointing to the floor!

Pseudo-Ptosis or Glandular Ptosis
Nipple is at the normal level, but the breast Parenchyma has slid down below the level of the Inframammary fold, giving the appearance of a bottomed-out breast.

During your consultation Dr. Younai will examine you to determine the degree of your breast’s ptosis. Then he will discuss with you in detail your treatment choices for Breast Lift & Mastopexy, including pros and cons of each procedure or technique, potential risks and complications, recovery course, pre and post operative instructions, and esthetic outcomes. There are also many before-and-after pictures and high resolution images of patients of Dr. Younai with different amount of breast ptosis which are available in our photo gallery.

Dr. Younai is a board certified plastic surgeon who receives patients at the California Center for Plastic Surgery from the Northern as well as the Southern California region. Some of these cities include Beverly Hills, Los Angeles, Santa Monica, Hollywood, Burbank, Sherman Oaks, Encino, Calabasas, Woodland Hills, Thousand Oaks, Westlake Village, Pasadena, Glendale, Valencia, Palmdale, Fresno, and Oxnard

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Dr. Sean Younai
is a Board Certified Cosmetic Plastic Surgeon, who practices in Encino, Los Angeles, Southern California.

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