Gravity is hard for everyone to escape, not only in the face, but also in the breasts, and today we talk about the aging of the breasts. I believe that many people have seen the breasts of older women, compared with the full and upright breasts of youth, aging breasts with sagging skin, sagging, areola nipple pigmentation, breastfeeding breasts will also be accompanied by the expansion of the areola and nipple enlargement. The sagging index of female gorillas is assessed against the above chart In the case of consistent earth gravity, large breasted girls face the problem of sagging earlier. A woman’s body carries a complex mission, and breastfeeding is a threshold that most women cannot cross. As women age, changes in the shape of their breasts undoubtedly cause them great distress, affecting their self-satisfaction and happiness in life. There are many surgical methods and devices used for breast lift, but the key is to form a long-term stable support structure to maintain the shape and position of the breast. Small and Sagging — Implants + Suture Suspension For patients with unsatisfactory breast volume, the main focus is on implants, with the aid of sutures to elevate the nipple areola if necessary. For small breasted girls, it can improve the sagging and at the same time enhance the cup size to achieve the dual effect of increasing the fullness of breast shape and overall enhancement. The idea of submammary fat fascia flap lift originated from the idea of breast reconstruction after breast-conserving surgery by Ogawa, a famous Japanese plastic surgeon: the submammary fat fascia flap is separated and folded back to fill the defective area caused by mastectomy, so as to achieve breast shape and overall lift. The idea of breast reconstruction after breast-conserving surgery by Dr. Ogawa is to separate the submammary fat fascial flap and fold it back into the defective area caused by mastectomy to restore the breast shape and volume. The black mass shows the submammary fat fascia flap. This procedure makes it possible for the flesh from the stomach to grow on the breast, and by lifting the submammary fat fascia flap with sutures, not only does it make the breast more lifted and increase in volume, but it also optimizes the abdominal line on a certain basis. As shown above, the fat flap inside the blue area is “fished” into the “breast” by the suspension and lifting effect of the suture, so that the submammary fat fascia flap becomes part of the breast in appearance, gaining a new submammary fold and increasing the volume of the breast, and it can It also provides some support. Patients can see not only the improvement of sagging breasts after surgery, but also the wonderful side effects of cup lifting and tummy tightening. Not small but sagging — Modified double ring method Using the traditional double ring method of circumareolar incision, removing the epidermis between the double rings, peeling between the skin and the glandular surface of the upper half of the breast, removing the deep layer of the superficial fascia that is flaccid after the upper half of the gland, lifting the gland to its normal position and fixing it to the deep fascia, and at the same time performing proper folding and shaping of the gland to increase the degree of fullness, for For girls who also want to increase their cup size, implantation of prosthesis can also be performed. The scar is only around the areola after surgery and is suitable for mild to moderate sagging or bilateral asymmetrical breasts. Immediate postoperative results Not small but sagging – support lamellae + suture suspension For patients with relatively satisfactory breast volume, the lamellae are implanted under the skin, outside the gland, and sutures are sutured through the lamellae and fixed to the upper pole of the breast at the fascial layer, relying on suspension to strengthen the internal support of the breast to optimize the overall shape of the breast. The above two breast lift/suspension procedures require incisions under the armpit, around the areola or in the inframammary fold for implantation, implantation of support lamellae and suture suspension over the fascia, which are relatively more traumatic. Not small but sagging — breast lift without surgery You may have heard that sagging of the face can t be lifted by thread sculpting, and on the same principle, sutures can be used for breast lift. The difference from the support lamellae + suture suspension mentioned above is that suture suspension alone does not use lamellae, eliminating the need for subcutaneous peeling and making it less invasive. Both methods do not increase the volume of the original breast, but rather enhance the overall shape of the breast through the suspension of multiple strands of sutures. Illustration of the suture suspension path In addition to regular sutures, the development and application of barbed sutures in recent years has provided a variety of options for breast lift suspension and fixation patterns. Large and Saggy – Breast Reduction + Breast Reshaping For patients with excess skin or breast tissue, the prerequisite for rebuilding the support structure must be the removal of excess tissue, and this type of patient is not suitable for direct lifting. And many patients also have an enlarged areola, the end result of which also requires a reduction of the areola to obtain a harmonious breast shape and, if necessary, nipple reduction. By removing excess skin, “rearranging” the skin on the surface of the breast and suturing it together, and lifting the relative positions of the nipple and areola, the overall shape of the breast is enhanced. Diagram of vertical hypothenarthroplasty 5 years after breast reduction + lift for patients with abundant glands 3 years and 8 months after breast lift for patients with predominantly lax skin In order to treat sagging breasts, the plastic surgeon needs to make surgical recommendations and communicate with the patient regarding the skin condition, degree of sagging, surrounding tissues, nipple position, breast shape, symmetry and other information in order to choose the final surgical procedure. The final procedure will be chosen. It is important to note that breast lift surgery requires a lot of clinical experience from the surgeon in charge compared to other cosmetic surgeries, so please choose your medical institution carefully when deciding to have a breast lift.