With time, pregnancies, or weight reduction, the breast volume (tissue) may become less, whilst the breast skin remains stretched. As a consequence, the breast will descend (ptosis), and may have a negative impact on a women's self esteem, well being and sense of attractiveness.

Mastopexy:

Mastopexy is a surgical procedure involving the removal of redundant breast skin around the areolar, and the lower part of the breast if necessary, in order to elevate the areolar, and tighten the breast skin envelope to achieve a higher nipple position, combined with a more pleasing breast shape and firmness.

Resultant scars can be either just around the areolar (bennelli), or around the areolar, extending to the crease under the breast (lollipop scar), or the above scars combined with a scar in the crease under the breast (an anchor scar). The extent of scarring depends on the amount of descent and skin excess, and can be discussed during the consultation.

Minor degrees of ptosis may be corrected using an implant to increase breast volume, but more extensive degrees often require breast implantation, combined with one of the above procedures, in order to achieve a pleasing, firm, natural beast shape again.

Breast reduction (reduction mammaplasty):

This surgical procedure is indicated when a women is disturbed by large, heavy, pendulous breasts, causing classical symptoms of discomfort, neck aches, shoulder indentation, skin rashes, limitations in activity and desired dressings.

Surgical reduction can be done in a variety of ways. It involves the removal of excess breast tissue, preserving, if possible, the glandular component and the sensation and blood supply to the nipple, repositioning the areolar higher, and reconstructing the breast into a firm, natural shape again.

Scars are inevitable, and are either around the areolar (bennelli), or extending down from the areolar to the inframammary crease (Le Jour), or in more severe cases the classical anchor incision, as described above.

In mild cases in young women with good skin tone, moderate degrees of breast enlargement can be reduced by liposuction alone, leaving minimal or no scars.