Sagging and downward nipple position is a common complaint in women who have given birth once or several times, or due to volume loss after excessive weight gain and loss.

Breast augmentation surgery increases breast volume and expands surface area. In breast lift surgery, the surface area of ​​the breast is usually reduced and the nipple is tried to be brought to its ideal position. In patients with sagging and volume loss in their breasts, augmentation and lifting procedures are performed at the same time. Combining two surgeries that have opposite functions makes this surgery the most difficult breast surgery for surgeons. Therefore, with this surgery, the skin surrounding the breast must be removed enough for breast augmentation and the nipples must be brought to their ideal position.

These surgeries are performed with the same three types of incisions described in breast lift surgeries. Depending on the severity of the sagging
Only done around the nipple (minimum sagging)
With an incision extending from the nipple to the lower breast groove (moderate sagging)
Made through an inverted T-shaped incision (for advanced sagging)

An important difference between this surgery and breast lift surgery is that less skin tissue is removed and the lack of volume is filled with silicone prostheses.

Can patients figure out for themselves which surgery they need?

There is a simple method for patients to understand whether they need only breast augmentation or breast lift + augmentation. If the position of the breast areola (the dark area around the nipple) has not sagged below the straight line drawn from the breast groove, augmentation with only a silicone implant will be sufficient. However, if it is below this line, a breast lift + augmentation surgery will be required. The only exception to this situation is glandular ptosis, where the tissues in the upper pole of the breast sag down even if the nipple has not sagged. In this case, breast lift + augmentation will probably be required. Or, breast augmentation can be achieved by filling the void in the upper pole with only fat filler injection. In Stage I patients, breast augmentation alone often solves the problem with a special technique.