Breast Laxity – Correcting Breast Ptosis with Breast Augmentation or Reduction Mammoplasty, or Breast Lift

Breast Laxity – Correcting Breast Ptosis with Breast Augmentation or Reduction Mammoplasty, or Breast Lift

Breast laxity is one of the most common complaints with ageing or after pregnancy. Breasts that have stretched or become lax typically have a lower position on the chest wall, often the upper breasts lack volume and the nipple and areola are pointing down instead of forward. Fortunately, there are several surgical solutions to correct these issues. The most popular procedure to elevate the breasts is breast lift or mastopexy surgery. Other options include Breast Implants (Augmentation Mammoplasty) or Breast Reduction (Reduction Mammoplasty) surgery.

Sydney Plastic Surgeon Dr Jeremy Hunt has performed hundreds of breast procedures.

Download the Guide to Breast Surgery

Standard Breast Surgery

Classification for Breast Laxity: Degree of Ptosis

The medical term we use to define breasts that sit low on the chest is breast ptosis. There are three different stages of breast ptosis. A suitable treatment plan can only be developed after assessing your level of breast ptosis or other breast conditions that look similar to breast ptosis.

When it comes to breast ptosis, we need to look at the position of the mammary gland compared to the inframammary fold – the crease under the breasts, where the breasts meet the chest wall. The ptosis is more or less severe depending on the amount of breast tissue that is positioned below the level of the inframammary fold.

Grade 1: Minor Breast Ptosis

If you have grade 1 breast ptosis it means that the nipple is at the same level or up to 1 cm below the inframammary fold. There are multiple options to correct grade 1 breast ptosis – the most popular is breast lift (mastopexy) surgery. A breast lift mastopexy is performed to eliminate the excess skin and lift the nipple and areola complex. The surgery can be performed in association with breast implants (breast augmentation mammoplasty) if you want to correct the ptosis and also add more volume to the upper breasts.

Grade 2: Moderate Breast Ptosis

In this case, the nipple is located 1-3 cm below the crease. A breast lift (mastopexy) procedure is often the best solution for this case and, just like it is the case for minor breast ptosis, the lift could be performed together with implants.

Grade 3: Severe Breast Ptosis

In this case, the nipple is positioned more than 3 cm under the inframammary fold level and it is pointing down, not to the front. To correct severe breast ptosis, breast lift (mastopexy) surgery is often recommended. When the ptosis is severe, more incisions might be needed to correct the issue.


Pseudo-ptosis, as the name implies, is a type of ‘fake’ ptosis. The breasts might look like they are low as there is breast tissue hanging below the inframammary fold level; however, the nipple and areola are in the correct anatomical position. Pseudoptosis can be corrected with the help of a breast augmentation mammoplasty surgery.

Parenchymal Maldistribution

Parenchymal maldistribution is characterised by a lack of fullness in the lower pole of the breast. The crease below the breasts is positioned high on the chest wall and there is a short distance from the nipple to the fold. The condition is similar to tuberous breasts and can be corrected using the breast procedure recommended by Dr Hunt after a medical examination.

What Causes Breast Laxity or Ptosis?

Breast ptosis occurs with the natural ageing process. However, there are other factors that could contribute to the early onset of breast ptosis including weight fluctuations, pregnancy, hormonal imbalance, genetic predisposition and high breast volume.

1. Ageing

Ageing, as mentioned above, causes the structural integrity of the skin to decrease significantly. This change, when combined with the downward stretching of the skin, due to gravity, results in significant breast ptosis. Many women experience this change in the shape of their breasts. It is important to note that these changes become more pronounced and visible after you hit menopause.

2. Excessive sun exposure

Sunburn or sun exposure without proper protection can result in damage to even the deepest layers of the skin, which consequently contributes to the stretching of skin.

3. Weight gain or weight fluctuations

Maintaining a healthy weight has many benefits, one of which is reduced skin laxity. If there is a significant amount of weight gain, that will also cause a change in the size of the breasts. A quick change in the size of breasts can cause rapid stretching of the overlying skin, resulting in stretched skin when this weight is lost. Weight gain also causes an increase in the breast tissue which makes them bigger and heavier. This can exaggerate the impact of gravity on the breasts.

4. Smoking

Smoking is extremely harmful to your physical health due to the high content of carcinogens and nicotine present in smoke. These carcinogens, or cancer-producing substances, also affect your skin and its elements, namely elastin. They break down elastin, making the skin lose its elastic nature and ability to return to its original form. Since the breast skin isn’t elastic anymore, it’s more likely to begin to show the effects of gravity.

5. Lack of proper support

It is highly recommended to wear a well-fitted bra that provides sufficient support to your breasts. While having no proper support may not cause any instant damage to your breast shape, over time, your breasts will begin to descend. This problem arises in the late 30s and 40s, although you may be avoiding wearing a bra during your 20s. Another important thing to remember is that wearing a bra alone is not enough if it doesn’t provide enough support to your breast. Wearing an ill-fitting bra that doesn’t cover your breasts entirely, or has a loose band, meaning that it doesn’t hold your breasts, can cause permanent damage to your breast structure in the long run.

6. Pregnancy

Breastfeeding was initially believed to be one of the most important factors responsible for breast laxity in women who have been pregnant and given birth. However, it was recently determined that breast ptosis or laxity is not the result of breastfeeding but rather the effect of significant breast size changes that occur during pregnancy.

How to Prevent Breast Ptosis

Prevention is always better than cure. You should try to take care of your breasts so that the structural integrity of your breasts is maintained. Taking necessary steps to prevent the breast ptosis can help slow down even the effect of ageing and gravity on your breasts. Some of the ways in which you can prevent breast ptosis are mentioned below:

  • Eating a nutritious diet, rich in antioxidants
  • Wearing a proper bra
  • Avoiding excessive sun exposure

How to Treat Breast Ptosis – Surgical Solutions

The best treatment of saggy breasts is determined by multiple factors, the most important being the breast ptosis grade. Based on the classification of the sagging, the treatment options and the surgical approaches can be very different. Here are the surgical solutions that can help you get perky breasts:

1. Breast Lift Mastopexy

A breast lift (mastopexy) is a surgical procedure performed to remove excess skin from the breasts and raise their position on the chest. It is performed after significant weight loss or multiple pregnancies that have left the with a lax or low appearance. A mastopexy procedure can be performed on its own or in combination with other procedures. The decision to combine procedures may be taken if the combination will be more beneficial in treating the breast ptosis than just performing a breast lift (mastopexy). The breast mastopexy could be performed together with a breast implants (augmentation mammoplasty) surgery and even a breast reduction mammoplasty to work towards achieving the patient’s desired outcomes. However, the breast lift (mastopexy) is often performed with liposuction and a tummy tuck/ Abdominoplasty as part of Post Pregnancy Surgery.

2. Breast Reduction Mammoplasty

A breast reduction mammoplasty procedure is often helpful in preventing further ptosis as it helps reduce the weight of the breast. For optimal treatment of ptosis or laxity, the procedure is often performed in combination with a breast mastopexy procedure. This combination procedure allows your surgeon to remove the breast tissue, while simultaneously removing the excess skin that will be present after the breast reduction mammoplasty procedure.

3. Breast Implants (Augmentation Mammoplasty)

Breast implants surgery, or breast augmentation mammoplasty, could be a good option for you if you have small breasts with minor breast ptosis. Placing a small breast implant, and repositioning the nipple and areola can improve the appearance of the breasts. A breast implant procedure will not only treat laxity but can also increase breast volume.

It is recommended to discuss the side effects of each procedure and your eligibility before making your decision. You should discuss the potential surgical solutions with your surgeon, in detail, so that you can make an informed decision with regards to the surgery you want to undergo.

FAQs about Breast Laxity and Surgical Solutions

How can I fix breast laxity (ptosis)?

  • The most popular procedure to correct breast ptosis is a breast lift mastopexy. However, in some cases, the procedure might be accompanied by a breast augmentation mammoplasty or reduction mammoplasty.

What causes breasts to descend?

  • There are multiple factors ranging from ageing and sun exposure to smoking that can cause your breasts to move downwards.

How do you lift your breasts with a bra?

  • Wearing a well-fitting bra that covers your breasts, and has a band that does not ride high on your back will provide your breasts with enough support to keep them in shape for longer.

Should I wear a bra to bed?

  • You can wear a bra to bed if that is what makes you comfortable. If you aren’t comfortable, you can opt to sleep without a bra.

Does going braless cause breast ptosis?

  • Lack of proper support is one of the most common causes of breast ptosis. You should always wear a supportive bra to maintain the structural integrity and shape of your breasts.

Further Reading about Breast Procedures

Medical References

About Dr Jeremy Hunt – Specialist Plastic Surgeon

Dr Jeremy Hunt

Dr Jeremy Hunt is a specialist plastic surgeon and a member of FRACS & ASPS. He has over 20 years of experience providing plastic surgery in Sydney.

Careful, considerate and honest, Dr Jeremy Hunt works with you to find a solution that is suitable for your body and your lifestyle. Every patient is unique and requires a personalised approach to reach their goals.

Dr Hunt has provided his one-on-one service and attention to detail to thousands of women and men from the Sydney & Wollongong NSW area and across Australia.

Dr Hunt’s qualifications and education

Dr Jeremy A. Hunt MBBS FRACS graduated with a Bachelor of Medicine degree from Sydney University in 1990 and is a Fellow of the Royal Australasian College of Surgeons and member of ASPS – the Australian Society of Plastic Surgeons. He completed a Fellowship at the University of Texas in the United States, where he learnt from well-established and experienced plastic surgeons.

Next Step – Make an Enquiry or Request a consultation with Dr Hunt

Want more information before scheduling your consultation?

If breast reduction mammoplasty is something you’re considering, Dr Hunt can thoroughly explain all the options to you in a one-on-one consultation.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health professional.