There are different techniques, depending on the severity of the sag:
Ultrasound breast lifting
In case of minor sagging and sufficient volume at the top, an ultrasound breast lifting can be performed. An ultrasound cannula sends energy beneath the skin to create new tissue and make the chest firmer. The biggest advantage of this technique is that there is no scarring. This method "melts" some of the fat resulting in firmer breast tissue. If all the glandular tissue is located at the bottom, or if the patient does not want the breast volume to be reduced, this method should be combined with the placement of an implant or another technique.
Mini breast lifting
The minilift procedure is possible if the positioning of the nipples is just a little low (the measurement from the dimple in between the clavical bones to the nipples = 22 – 25 cm). The procedure can be performed under local anaesthesia and results in a small scar around the nipples. The sensation in the nipple is preserved, as well as the possibility to breastfeed. With the development of a new technique using very supple permanent sutures, we are able to reduce the occurence of folds and broad scars to a minimum.
Breast lifting
In case of severe sagging, the ultrasound breast lift or the mini breast lift are no longer sufficient. If the nipples are clearly positioned below the fold under the breast, or if the distance from the nipple to the clavicle is more than 24 cm, a full breast lift is the only option to obtain a good result. During this procedure the nipple is moved upward, leaving a scar behind. Excess skin is also removed under the breast. This creates a scar from the areola downwards. The breast tissue itself is folded for a tight result. A lot of people think that the nipple is removed and subsequently put back. This is not quite the case. The nipple remains attached to the mammary gland, blood vessels and nerves. In fact, only the superficial skin around the areola is detached to move the nipple. Breastfeeding is still possible in most cases, and sensations and blood supply are also left intact.
Breast lifting with muscle (GRAF lifting)
If only a lifting effect is necessary, and the breast volume is good, a lifting technique may be employed which uses the pectoralis major muscle as a permanent internal bra. This allows the mammary gland to remain higher and firmer for a longer-term effect.
Combination breast lifting and enlargement
A slight lifting effect can be also obtained by enlarging the breasts. However, when the nipple is positioned too low, a combination of both procedures is necessary.