Breast Ptosis: How Breasts Sag & Why

The Degree of Sagging Can Help Determine Your Breast Lift Options

Dr. Paul Parker
Based on your individual genetics, pregnancy history and weight changes, breasts will sag to varying degrees. Plastic surgeons use a classification system to categorize the degree of breast sagging, or ptosis, as shown in the schematic below. As a plastic surgeon serving women from Ridgewood and Paramus, NJ, this classification system also helps me determine what breast lift options are best for an individual based on the amount of their breast ptosis.

Breast Ptosis Diagram: Measuring Your Degree of Sagging

Diagram showing grades of breast ptosis
  • normal breast has the nipple and parenchyma (glandular tissue and fat which compose the breast) of the breast sitting above the crease underneath the breast, or the inframammary fold.
  • Grade 1 ptosis is mild sagging in which the nipple lies at the level of the inframammary fold and the parenchyma below it.
  • Grade 2 ptosis is moderate sagging in which the nipple lies below the level of the inframammary fold but remains above the lowest hanging (or most dependent) part of the parenchyma.
  • Grade 3 ptosis is severe sagging in which the nipple lies well below the inframammary fold and lies at the bottom of the breast, at the lowest hanging part of the parenchyma along the inferior contour of the breast.
  • Pseudoptosis is not true ptosis, because the nipple lies above or at the level of the inframammary fold. However, the majority of the breast parenchyma has descended below the level of the fold.
  • Parenchymal maldistribution involves a lack of fullness in the lower portion of the breast, a high inframammary fold and a relatively short distance from the fold to the nipple, seen in conditions such as a tuberous breast.

Watch this animated video to learn more about how breasts can begin to sag.

Why Are My Breasts Sagging?

While many consider firm, perky and round breasts as the norm, it’s very common for a woman to experience sagging at some point in her life. Breasts can develop ptosis, or start to sag, for the following reasons:

  • Congenital: Some girls will develop with breasts that sag and have downward pointing nipples. These patients are often self-conscious about the appearance of their breasts. Surgical treatment such as breast augmentation with mastopexy (breast lift) will not only improve the appearance of the breasts but usually will also improve body image, self esteem and social development.
  • Post pregnancy: Breasts become engorged during pregnancy and nursing, then decrease in size and often droop afterwards. The problem is usually worsened with each pregnancy, and patients are often bothered by the loss of their previously attractive breasts. A breast lift or augmentation mastopexy will create perkier, more youthful looking breasts and allow these patients to feel more comfortable with their bodies, which can provide a psychological lift.
  • Weight loss: With weight gain, the skin and support structures of the breast stretch. With weight loss, sagging occurs if the tissues do not have enough elasticity to regain their shape. A mastopexy or augmentation mastopexy will often help correct this, improving self-confidence.
  • Aging: The skin and support structures of their breast lose their tone and elasticity over time. Gravity causes these tissues to stretch and the breasts to sag. A mastopexy or augmentation mastopexy will allow the breasts to look more youthful, improving self-confidence.

If you would like to explore breast lift or breast augmentation plastic surgery at our New Jersey practice, contact us online to request a consultation.

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