Breast ptosis is one of the more common issues seen in plastic surgeons’ offices, particularly those performing a significant amount of aesthetic breast surgery. Although ptotic breasts can be developmental and occur during breast growth at puberty, the image of drooping breasts elicits a sense of aging and loss of femininity for most patients. Beautifully shaped, “perky” breasts – regardless of size – are a symbol of youth and sexuality, and the lack of this trait can cause insecurity and selfesteem issues for many women. Mastopexy will focus on the relatively narrow spectrum of women who have a relatively appropriate amount of breast volume, but are lacking the shape and position associated with a youthful and aesthetic breast. In these women, the primary treatment is rearrangement of the breast parenchyma combined with skin excision and re-draping. Possible small volume addition (via fat grafting) or small volume reduction (via direct tissue resection and/or liposuction) will also be discussed within the context of creating the best possible final breast shape and correcting preoperative asymmetry in women who otherwise have adequate volume.
