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What is Pencil Test for Sagging Breasts?

December 23rd, 2014

pencil test

What is the pencil test? Plastic surgeons use this test to measure the extent of  ptosis  of the breast, a medical term to describe droopy or sagging of the breasts. According to  The American Society for Aesthetic Plastic Surgery,  more than 127,000 had breast lift surgery last year and it ranks in the top 5 of requested cosmetic surgery procedures. When a woman is considering having surgery to correct sagging, several factors are taken into consideration. Sagging of a woman’s breasts can occur due to any significant weight change, such as after a pregnancy.  True ptosis or sagging  refers to nipple position falling below the crease beneath your breast. The “pencil  test” is the way to find out if surgery might be indicated. By placing a pencil beneath your breast and if your nipple hangs below the pencil when you sit or stand, then you may need a breast lift. If the nipple is above, increasing the fullness may correct this. For more information, see  Breast Augmentation  and  Lipo Fat Grafting for Natural Breast  Enlargement.

Breast lift surgery repositions the nipple and areola (pigmented skin around the nipple) upwards to a more natural position.  This natural position is about ½-3/4 of an inch above the crease under the breast.  Careful positioning is important. Positioning them higher than this may result in an odd breast appearance.  The size of the areola can also be reduced during surgery at the same time, if the patient desires. Breast list surgery is an effective remedy for droopy or sagging breasts and restores a more natural appearance to the breasts.

Scars from a breast lift are the similar to breast reduction surgery and are positioned around the nipple and beneath the breast as well. They are usually covered by most swimming suits. Many women can still breastfeed following breast lift surgery, if they choose to do so. However, it is not uncommon for women to choose to have completed having children before scheduling a breast lift or reduction surgery.

Most of my patients return to work 2 days following surgery with some activity restrictions. Both breast reduction and lift patients report being pleased with the change in their figure after the procedure and are happy with their decision to have surgery.  

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Breast Reduction: Options

December 7th, 2011

Just as some women may experience a decrease in breast size over time, others will notice an increase in breast size.  When a woman is uncomfortable with having too much breast tissue, there are several options to correct this condition. A  dramatic  increase in size may result of an increase in overall weight gain or a pronounced sagging of the breast tissue.  Increase of breast size may result in physical discomfort, including  symptoms like neck pain, back pain, shoulder grooving and irritation beneath the breasts.  Patients routinely turn  to breast reduction surgery to reduce their symptoms, along with their breast size.

Reducing breast size can be done with direct surgical removal of breast tissue or with liposuction.   Liposuction does not adjust nipple position.   It is effective only when there are significant amounts of fat in the breasts.  Young women may not be candidates for this surgery because of the relatively low amount of breast fat.  Traditional breast reduction surgery reduces breast size through excision of breast tissue, while repositioning the  nipple and areola (pigmented skin around the nipple).  The size of the areola  can also be reduced.   Scars, which are similar to breast lift surgery, are placed around the nipple and beneath the breast as well.  Scars will be less noticeable as they continue to heal.

I recommend that any breast tissue removed be sent for examination by a pathologist.   This includes a   visualization under a microscope after tissue  staining to determine the presence of conditions or abnormalities which might increase chances of breast cancer.   On rare  occasions, breast cancer is diagnosed this way.

My patients choose of their final size, based on decisions made during our office consultation.  A range of implant “sizers” are helpful in this regard.
Time to schedule reduction surgery following pregnancy is determined by normal involution of breast tissue and the end to breast-feeding.   Generally this takes six months to a year after delivery or three months after breast-feeding.  Unfortunately, some women will not be able to breast feed again after breast reduction surgery.  Therefore, if breast-feeding  is an important consideration, I advise my patients to postpone breast reduction surgery until they are finished having children.

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