Many patients who visit our clinic concerned about breast sagging (breast ptosis)

are often diagnosed upon actual examination not with true ptosis, but with "deflated breasts" caused by a loss of upper pole volume.


Conversely, there are also many cases where patients assume it is merely a minor loss of volume,

yet an advanced stage of ptosis is present that absolutely requires

breast ptosis correction (mastopexy / breast lift).


The reason these two conditions must be accurately distinguished is clear:

the required surgical approach and incision method differ completely depending on the underlying cause.


Here is a simple guideline you can use to check at home in just 30 seconds whether your breasts are sagging or simply deflated.



1. Self-Diagnosis for Breast Ptosis: The Relative Position of the Nipple to the Inframammary Fold


The most objective criterion used medically to determine breast ptosis

is the relationship between the inframammary fold (IMF) and the height of the nipple.


Stand in front of a mirror with good posture and observe the position of your nipples

relative to the lower crease where the breast meets the chest wall (the inframammary fold).


  • Grade 1 (Pseudoptosis / Deflated Breasts): The nipple is positioned clearly above the inframammary fold.


This is not a sagging of the tissue itself, but rather an appearance of sagging caused by volume loss in the soft tissue and fat of the upper breast.

In this case, simply restoring volume through breast implants or fat grafting without any lift incisions

can achieve a visually lifted, rejuvenated improvement.


  • Grade 2 (Mild Ptosis): The nipple is positioned almost at the same level as the inframammary fold.


This is the stage where true breast ptosis begins,

requiring a thorough evaluation of volume status and skin elasticity to determine whether surgical incision correction is needed.


  • Grade 3 (Moderate to Severe Ptosis): The nipple has dropped 1 to 3 cm or more below the inframammary fold.


Volume restoration alone cannot adequately support the stretched glandular tissue and skin.

A combined breast lift surgery to reposition the sagging tissue upward must be considered.


2. Surgical Approaches According to the Degree of Ptosis


The key to breast surgery is not fitting the surgical technique to a "desired scar size,"

but matching the appropriate surgical technique to the "current degree of ptosis."



  • Volume Restoration (Breast Augmentation)


Indicated when there is volume deflation without true ptosis.

Using minimal incisions, such as along the inframammary fold or through the axilla (armpit), the deflated space is filled to restore the breast's naturally firm, youthful contours.


  • Periareolar (Benelli) Mastopexy


Suitable for mild ptosis requiring slight upward repositioning of the nipple.

The scar is placed along the border of the areola, offering the advantage of becoming less noticeable over time.


  • Vertical & Inverted-T (Wise Pattern) Mastopexy


Indicated for moderate to severe ptosis where the nipple and the entire glandular tissue must be significantly repositioned upward.

While longer incision lines are involved, this is the definitive, essential method to achieve reliable, lasting improvement for severe ptosis.


If one insists only on minimal incision techniques to reduce scarring despite significant ptosis,

"undercorrection" may occur, leaving the sagging unresolved.


Conversely, applying extensive incisions to mild ptosis can result in unnecessary scarring;

therefore, precise surgical planning tailored to each individual grade must come first.


3. Four Daily Habits to Slow the Progression of Breast Ptosis


Here are fundamental principles to follow in your daily life to maintain skin elasticity, both before surgical treatment and during post-operative care.



1) Avoid Rapid Weight Loss


Losing weight rapidly—more than 5 kg in a single month—prevents the skin's contraction rate

from keeping pace with fat reduction, accelerating breast sagging significantly. (A steady loss of 1–2 kg per month is recommended.)


Recently, concerns regarding sagging have increased noticeably among patients

who experience repeated weight cycling after rapid weight loss with diet injections.


2) Wear a Sports Bra During High-Intensity Exercise


During activities involving significant vertical movement, such as running,

wearing a sports bra with sufficient support is essential.


For those with naturally large breasts or who have undergone breast augmentation,

wearing a supportive sports bra is a must.


3) Wear a Sleep Bra


If you have a habit of sleeping on your side, prolonged gravity and pressure

can cause breast tissue to shift and compress.


A non-compressive sleep bra significantly relieves this unilateral shifting.


4) Be Cautious with Excessive Massage


Deep, forceful breast massage can weaken the supportive Cooper's ligaments,

so any massage should be performed with gentle pressure.


Key Points to Verify During Your Breast Surgery and Ptosis Correction Consultation


"Does the surgeon actually measure the distance between the nipple and the inframammary fold and provide an objective grade of ptosis?"


"Are the differences between minimal-scar techniques and methods offering definitive correction explained clearly?"


"If the patient's preferred incision method does not match their grade of ptosis,

are the medical rationale and potential limitations clearly outlined?"


Determining the need for a breast lift requires a rigorous anatomical diagnosis based on nipple position.