What is Ptosis?

Ptosis is the medical term for drooping or sagging. It is a natural occurrence with aging. Other reasons for ptosis include genetics, large breast size, multiple pregnancies, increased age, obesity, cigarette smoking, and poor skin tone and poor tissue elasticity related to hereditary factors. More recent research has shown that breast-feeding does not aggravate sagging. Vigorous exercise without proper bra support may aggravate sagging. Regular bra support has not be proven to prevent sagging, as sagging occurs related to the factors mentioned above regardless of regular bra wear.

Degrees of Ptosis

It is always interesting to see how people perceive themselves. Most women are not aware of their breasts until they come in for a consultation for cosmetic breast surgery, upon which their plastic surgeon makes them aware of preexisting asymmetries and sagging. It is surprising how many women come in for consultation, denying any degree of sagging, and are found to have severe sagging. On the other hand, some women come in complaining of sagging, are there is no sagging whatsoever. Patients who are not ptotic but complain of sagging usually have postpartum sub involution of breast tissue. Postpartum breast involution is the term that describes the shrinking of milk-producing structures of the breast to their pre-pregnancy size when they are no longer needed.

Here’s how to determine whether or not you are ptotic:

  • Find a ruler.
  • Take your shirt and bra off and find your inframammary crease (the natural fold under your breasts where they meet your chest).
  • Place the ruler in the crease, directly against the junction of the breast and ribcage.
  • Let your breasts hang over the ruler, and look at yourself in a mirror. The ruler marks your inframammary crease.

If your nipple is slightly above or directly in front of the top of the ruler, you have Grade 1 ptosis. This is considered mild ptosis.

If the central point of your nipple is 2-6 cm below the ruler, you have Grade 2 ptosis. This is considered moderate ptosis.

If the central point of your nipple and your areola is more than 7 cm below your breast crease, you have Grade 3 ptosis. This is considered severe ptosis. Nipples pointing towards the floor characterize severe ptosis.

Pseudoptosis occurs when the nipple is still above the inframammary crease, but the bottom of the breast appears to droop because of a large sagging gland.

Nipple ptosis means that the nipples are low on the breast mound. The nipples are sagging; the majority of the breast gland is small and non-ptotic.

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