Ptosis (breasts)
Encyclopedia
Ptosis of the breast refers to drooping or sagging of the breast. Breast ptosis is related to the laxity of the superficial fascia
, suspensory ligaments
and skin.
Ptosis is a natural part of the aging process, though the rate at which a woman develops ptosis depends on many factors. Ptosis can result after pregnancy, or after weight gain and subsequent loss. Breast size is a factor in ptosis, with larger breasts becoming ptotic more quickly. Pseudoptosis is the condition where the nipple is at the level of the inframammary crease, but the breast itself has not dropped. Surgeons offering plastic surgery to address ptosis categorize the condition by the relationship that the nipple
has to the inframammary crease.
s are composed of soft, glandular tissue, with few support structures, such as connective tissue
. Breasts are composed of the mammary gland
s, which remain relatively constant throughout life, as well as the adipose tissue
or fat tissue that surrounds the mammary glands. It is the amount and distribution of adipose tissue and, to a lesser extent, glandular tissue that leads to variations in breast size. In addition, the breasts contain ligaments
, although their exact function as related to breast support has not been agreed upon by experts. These ligaments, and the overlying skin
(referred to as the dermal brassiere) help determine the resulting breast shape.
As the breasts mature, they fold over the lower attachment to the chest wall (infra-mammary fold), and their lower (inferior) surface lies against the chest wall when vertical. In popular culture, this maturation is referred to as "sagging" or "drooping", although plastic surgeons refer to it as ptosis. The surgical procedure to lift the breast is called mastopexy.
to provide breast support, based on the presumption that breasts cannot support themselves.
Health professionals have, however, found no evidence to suggest that wearing a bra for any amount of time slows ptosis of breasts.
Deborah Franklin, a senior writer in science and medicine, wrote in Health magazine that, "Still, the myth that daily, lifelong bra wearing is crucial to preserving curves persists, along with other misguided notions about that fetching bit of binding left over from the days when a wasp waist defined the contours of a woman’s power."
Franklin interviewed Dr. Christine Haycock a surgeon at the New Jersey Medical School
and an expert in sports medicine
. Dr. Haycock said that "Cooper's ligaments
have nothing to do with supporting breast tissue... They just serve to divide the breast into compartments." She noted that most women's breasts begin to droop with age and that extremely large-breasted women are generally more affected. However, sagging is not related to ligaments or dependent on breast size.
While large-breasted women may be uncomfortable exercising without a bra, Dr. Haycock said that “It’s not doing any lasting damage to chest muscles or breast tissue.” Her research found that “those who wore an A cup were frequently most comfortable with no bra at all."
There are some indications that wearing a bra may have an effect opposite to that which was intended. In a Japanese study, 11 women were measured wearing a standardised fitted bra for three months. They found that breasts became larger and lower, with the underbust measurement decreasing and the overbust increasing, while the lowest point of the breast moved downwards and outwards. The effect was more pronounced in larger-breasted women. This may be related to the particular bra chosen for the experiment, as there was some improvement after changing to a different model. These findings were confirmed in a much larger French study of 250 women who exercised regularly and were followed by questionnaires and biometric measurements for a year after agreeing not to wear a bra. While there was some initial discomfort at the first evaluation, this gradually disappeared and by the end of the year nearly all the women had improved comfort compared to before the study. The measurements showed firmer, and more elevated and youthful breasts. One example is given of a woman who had breasts that were uncomfortably large, and who had improvement after two years of being without a bra.
Breasts naturally change in shape and size as women age. There are conflicting opinions but no known studies to show whether bras actually delay or reverse the natural process. Health ethicist
s are concerned that plastic surgery and implants have altered our concept of what is "normal" and medicalised women's bodies by making the normal aging process a "disease."
to make their breasts less ptotic. Procedures used include mastopexy, placement of breast implants, or both. If sagging is present and the woman opts not to undergo mastopexy, implants are typically placed above the muscle, to fill out the breast skin and tissue. Submuscular placement can result in a snoopy deformity effect. In these cases, the implant appears to be high on the chest, while the natural breast tissue hangs down over the implant.
When the gravity pulls the breasts down, those ligaments and the skin can stretch, and so the breast then droops. This depends on the elasticity of your skin and of your ligaments, as determined by your genes and diet, and also on normal aging processes. Obviously large breasts will sag easier since the gravity is pulling them down more. When breasts bounce during active sports, such as tennis, those ligaments can also be stretched or even torn. A good sports bra can minimize that effect.
Breast involution is a process where the milk-making system inside the breast shrinks because it is not needed anymore. This happens either after weaning, or right after pregnancy if the woman does not breastfeed at all, or during menopause. When the tissues inside the breast shrink, and the skin surrounding it doesn't, the breast can look "empty" and saggy. After weaning, a woman's body does usually deposit fat back to the breast (this process takes months), so that breasts will gain their pre-pregnancy size, but sagging usually remains.
Another common cause for sagging is when a woman loses weight. When you lose weight, some of that fat disappears from your breasts. Typically the skin and the ligaments inside the breasts do not retract accordingly, resulting in an 'empty' looking breast that then sags. (You could try prevent this by eating foods that provide extra good nutrition for your skin.)
An evolutionary theory for breasts sagging is the idea of a woman being able to feed one child behind her whilst still performing everyday tasks in front of her, although due to the modern age and device such as bottles (prohibit breast feeding) and bras (more muscle support so will be less likely to waste as quickly). This method is thought to have died out with the remaining tribes of Africa.
Clavipectoral fascia
The clavipectoral fascia is a strong fascia situated under cover of the clavicular portion of the Pectoralis major....
, suspensory ligaments
Cooper's ligaments
Cooper's ligaments are connective tissue in the breast that help maintain structural integrity.Transmission diffraction tomography can reveal the anatomy....
and skin.
Ptosis is a natural part of the aging process, though the rate at which a woman develops ptosis depends on many factors. Ptosis can result after pregnancy, or after weight gain and subsequent loss. Breast size is a factor in ptosis, with larger breasts becoming ptotic more quickly. Pseudoptosis is the condition where the nipple is at the level of the inframammary crease, but the breast itself has not dropped. Surgeons offering plastic surgery to address ptosis categorize the condition by the relationship that the nipple
Nipple
In its most general form, a nipple is a structure from which a fluid emanates. More specifically, it is the projection on the breasts or udder of a mammal by which breast milk is delivered to a mother's young. In this sense, it is often called a teat, especially when referring to non-humans, and...
has to the inframammary crease.
Overview
Anatomically, the breastBreast
The breast is the upper ventral region of the torso of a primate, in left and right sides, which in a female contains the mammary gland that secretes milk used to feed infants.Both men and women develop breasts from the same embryological tissues...
s are composed of soft, glandular tissue, with few support structures, such as connective tissue
Connective tissue
"Connective tissue" is a fibrous tissue. It is one of the four traditional classes of tissues . Connective Tissue is found throughout the body.In fact the whole framework of the skeleton and the different specialized connective tissues from the crown of the head to the toes determine the form of...
. Breasts are composed of the mammary gland
Mammary gland
A mammary gland is an organ in mammals that produces milk to feed young offspring. Mammals get their name from the word "mammary". In ruminants such as cows, goats, and deer, the mammary glands are contained in their udders...
s, which remain relatively constant throughout life, as well as the adipose tissue
Adipose tissue
In histology, adipose tissue or body fat or fat depot or just fat is loose connective tissue composed of adipocytes. It is technically composed of roughly only 80% fat; fat in its solitary state exists in the liver and muscles. Adipose tissue is derived from lipoblasts...
or fat tissue that surrounds the mammary glands. It is the amount and distribution of adipose tissue and, to a lesser extent, glandular tissue that leads to variations in breast size. In addition, the breasts contain ligaments
Cooper's ligaments
Cooper's ligaments are connective tissue in the breast that help maintain structural integrity.Transmission diffraction tomography can reveal the anatomy....
, although their exact function as related to breast support has not been agreed upon by experts. These ligaments, and the overlying skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
(referred to as the dermal brassiere) help determine the resulting breast shape.
As the breasts mature, they fold over the lower attachment to the chest wall (infra-mammary fold), and their lower (inferior) surface lies against the chest wall when vertical. In popular culture, this maturation is referred to as "sagging" or "drooping", although plastic surgeons refer to it as ptosis. The surgical procedure to lift the breast is called mastopexy.
Impact of bras
Although the exact mechanisms that determine breast shape and size are largely unknown, it is commonly accepted that sagging occurs when a breast's normal anatomical support is inadequate to support the weight of the breasts. Many women wear a brassiereBrassiere
A brassiere is an undergarment that covers, supports, and elevates the breasts. Since the late 19th century, it has replaced the corset as the most widely accepted method for supporting breasts....
to provide breast support, based on the presumption that breasts cannot support themselves.
Health professionals have, however, found no evidence to suggest that wearing a bra for any amount of time slows ptosis of breasts.
Deborah Franklin, a senior writer in science and medicine, wrote in Health magazine that, "Still, the myth that daily, lifelong bra wearing is crucial to preserving curves persists, along with other misguided notions about that fetching bit of binding left over from the days when a wasp waist defined the contours of a woman’s power."
Franklin interviewed Dr. Christine Haycock a surgeon at the New Jersey Medical School
New Jersey Medical School
New Jersey Medical School is one of eight schools that comprise the University of Medicine and Dentistry of New Jersey . NJMS is the oldest school of medicine in New Jersey, predating its broader parent institution, UMDNJ, by 16 years...
and an expert in sports medicine
Sports medicine
Sports medicine is a branch of medicine that deals with physical fitness, treatment and prevention of injuries related to sports and exercise...
. Dr. Haycock said that "Cooper's ligaments
Cooper's ligaments
Cooper's ligaments are connective tissue in the breast that help maintain structural integrity.Transmission diffraction tomography can reveal the anatomy....
have nothing to do with supporting breast tissue... They just serve to divide the breast into compartments." She noted that most women's breasts begin to droop with age and that extremely large-breasted women are generally more affected. However, sagging is not related to ligaments or dependent on breast size.
While large-breasted women may be uncomfortable exercising without a bra, Dr. Haycock said that “It’s not doing any lasting damage to chest muscles or breast tissue.” Her research found that “those who wore an A cup were frequently most comfortable with no bra at all."
There are some indications that wearing a bra may have an effect opposite to that which was intended. In a Japanese study, 11 women were measured wearing a standardised fitted bra for three months. They found that breasts became larger and lower, with the underbust measurement decreasing and the overbust increasing, while the lowest point of the breast moved downwards and outwards. The effect was more pronounced in larger-breasted women. This may be related to the particular bra chosen for the experiment, as there was some improvement after changing to a different model. These findings were confirmed in a much larger French study of 250 women who exercised regularly and were followed by questionnaires and biometric measurements for a year after agreeing not to wear a bra. While there was some initial discomfort at the first evaluation, this gradually disappeared and by the end of the year nearly all the women had improved comfort compared to before the study. The measurements showed firmer, and more elevated and youthful breasts. One example is given of a woman who had breasts that were uncomfortably large, and who had improvement after two years of being without a bra.
Breasts naturally change in shape and size as women age. There are conflicting opinions but no known studies to show whether bras actually delay or reverse the natural process. Health ethicist
Ethicist
An ethicist is one whose judgment on ethics and ethical codes has come to be trusted by a specific community, and is expressed in some way that makes it possible for others to mimic or approximate that judgement...
s are concerned that plastic surgery and implants have altered our concept of what is "normal" and medicalised women's bodies by making the normal aging process a "disease."
Mastopexy
Some women with ptosis choose to undergo plastic surgeryPlastic surgery
Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic: plastic surgery includes many types of reconstructive surgery, hand...
to make their breasts less ptotic. Procedures used include mastopexy, placement of breast implants, or both. If sagging is present and the woman opts not to undergo mastopexy, implants are typically placed above the muscle, to fill out the breast skin and tissue. Submuscular placement can result in a snoopy deformity effect. In these cases, the implant appears to be high on the chest, while the natural breast tissue hangs down over the implant.
When the gravity pulls the breasts down, those ligaments and the skin can stretch, and so the breast then droops. This depends on the elasticity of your skin and of your ligaments, as determined by your genes and diet, and also on normal aging processes. Obviously large breasts will sag easier since the gravity is pulling them down more. When breasts bounce during active sports, such as tennis, those ligaments can also be stretched or even torn. A good sports bra can minimize that effect.
Breast involution is a process where the milk-making system inside the breast shrinks because it is not needed anymore. This happens either after weaning, or right after pregnancy if the woman does not breastfeed at all, or during menopause. When the tissues inside the breast shrink, and the skin surrounding it doesn't, the breast can look "empty" and saggy. After weaning, a woman's body does usually deposit fat back to the breast (this process takes months), so that breasts will gain their pre-pregnancy size, but sagging usually remains.
Another common cause for sagging is when a woman loses weight. When you lose weight, some of that fat disappears from your breasts. Typically the skin and the ligaments inside the breasts do not retract accordingly, resulting in an 'empty' looking breast that then sags. (You could try prevent this by eating foods that provide extra good nutrition for your skin.)
An evolutionary theory for breasts sagging is the idea of a woman being able to feed one child behind her whilst still performing everyday tasks in front of her, although due to the modern age and device such as bottles (prohibit breast feeding) and bras (more muscle support so will be less likely to waste as quickly). This method is thought to have died out with the remaining tribes of Africa.