As time passes, many women begin to notice changes in the shape, positioning, and firmness of their breasts. One of the most common and natural changes involves breast ptosis, more commonly known as breast sagging. While a normal part of aging, sagging breasts can also affect self-confidence, body image, and comfort. Fortunately, effective solutions are available — including surgical procedures like a breast lift, which is considered the gold standard for correcting breast ptosis.

Below, Santa Barbara plastic surgeon Wesley Schooler, MD explores common signs of breast ptosis, potential causes, and the most effective options for restoring youthful, perky breasts.

What is Breast Ptosis?

Breast ptosis is the medical term for sagging breasts. It occurs when the breast tissue and skin lose their elasticity and the breast begins to drop on the chest wall. Ptosis can range from mild to severe, depending on the position of the nipple relative to the inframammary fold (the crease under the breast).

Grades of Breast Ptosis

Plastic surgeons typically classify breast ptosis into three main categories:

• Grade I (Mild): The nipple is at the level of the inframammary fold.
• Grade II (Moderate): The nipple is below the fold but still above the lower contour of the breast.
• Grade III (Severe): The nipple is significantly below the fold and points downward.

Signs and Symptoms of Breast Ptosis

Recognizing the signs of breast ptosis can help you determine when it may be time to consider corrective measures. The most common signs of breast ptosis include:

• Downward-pointing nipples
• Nipples falling below the breast crease
• Loss of upper breast fullness
• Flattened or elongated breast shape
• Loose, stretched skin
• Skin irritation or chafing under the breasts
• Difficulty finding well-fitting bras

Causes of Breast Ptosis

Breast ptosis is a part of the natural aging process, but rarely caused by a single factor. Usually, it’s a combination of several external and internal forces. Some of the most common causes include:

• Aging: As you age, the skin and ligaments that support your breasts naturally lose collagen and elasticity.
• Pregnancy and Breastfeeding: The breasts expand and contract significantly during pregnancy and nursing, which stretches the skin and tissues.
• Weight Fluctuations: Gaining and losing weight can stretch the skin and lead to loss of volume, which can both contribute to sagging.
• Genetics: Your skin quality, breast size, and natural elasticity are often inherited traits that influence your likelihood of developing ptosis.
• Smoking: Smoking breaks down elastin in the skin, accelerating the loss of firmness and elasticity.
• Large, Heavy Breasts: Larger breasts are more susceptible to the pull of gravity, leading to faster and more pronounced sagging.

While some non-surgical methods like a supportive bra or losing weight may temporarily improve the appearance of the breasts or strengthen the pectoral muscles beneath them, none can significantly reverse true breast ptosis — especially when sagging is moderate to severe.

Solutions: Breast Lift Surgery

The most effective and reliable way to correct sagging breasts is through breast lift surgery, also known as mastopexy. A breast lift is a surgical procedure designed to raise and reshape sagging breasts by removing excess skin, tightening the surrounding tissue, and repositioning the nipples to a more youthful positioning. In some cases, it can be combined with breast implants during breast augmentation to restore lost volume.

Whether alone or performed in combination with other treatments, a breast lift can:

• Elevate the breasts to a youthful position
• Reposition the nipples and areolas
• Restore firmness and contour
• Improve breast symmetry
• Boost self-confidence and comfort in clothing

Breast ptosis is a natural and common occurrence, but that doesn’t mean you have to live with sagging breasts if they affect your confidence or comfort. While non-surgical methods may offer minor aesthetic benefits, breast lift surgery remains the most effective and lasting solution for restoring a youthful, lifted contour.

If you have any questions about a breast lift, please contact Dr. Schooler at our Santa Barbara practice today.

Cleavage refers to the visible space between your breasts, typically seen when the breasts are pushed together. It’s most noticeable when the breasts are fuller and closer together, often accentuated by specific outfits, bras, and swimsuits. Patients can lose cleavage over time due to several factors related to aging, hormonal changes, and lifestyle. As women age, the skin and ligaments that support the breasts (Cooper’s ligaments) lose elasticity, causing the breasts to sag or flatten. Additionally, the production of collagen and elastin decreases, leading to reduced firmness in the breast shape. If you feel like your breasts have aged or lost volume over time, cosmetic procedures may be able to help you restore cleavage and reclaim a more voluptuous, sensual silhouette. 

In many cases, cleavage can be enhanced using breast implants. Saline and silicone implants have the ability to enhance volume and fullness in the breasts, improving projection and creating a rounder, more youthful breast shape in the process. Patients who also deal with sagging may consider a breast lift with implants — a combination breast augmentation and mastopexy procedure — to simultaneously increase cleavage and rejuvenate the positioning of the breasts. That said, it’s important to remember that achieving visible cleavage also depends on anatomical factors, such as the nature of your body frame and how widely your breasts are spaced apart. A wide distance between the breasts is often observed in women who have gone through menopause, and may inhibit patients from gaining the increased cleavage they desire. Dr. Schooler will let you know what’s possible with regard to enhancing cleavage during your consultation. 

Dr. Wesley Schooler has a thorough understanding of the aesthetic procedures that can help you achieve your goals, and he would be happy to discuss potential treatment options with you based on your hopes for the outcome. Contact Santa Barbara Plastic Surgery today for more information about breast surgery, or to book a consultation with our board-certified plastic surgeon. 

There are many factors that can cause the look and feel of the breasts to change over time, from genetic predisposition and weight gain to menopause and pregnancy. Eventually, patients in Santa Barbara and beyond may notice their breasts beginning to flatten, or observe early signs of ptosis (breast drooping). While Dr. Wesley Schooler — our board-certified plastic surgeon — understands that the loss of your youthful breast contours can be distressing, you don’t have to live with these changes forever. Modern advances in cosmetic surgery have made it safe, effective, and predictable to treat age-related changes in the breasts with a number of advanced procedures:

• Breast Lift: As the “gold standard” of breast rejuvenation for many patients, mastopexy removes excess, stretched-out skin and reshapes breast tissue. Combined, these enhancements achieve a firmer, more projected, and “perkier” breast profile.
• Breast Augmentation: Implants fill the upper poles of the breasts and add volume, making the breasts look fuller and more youthful. They also enhance the contour of the breasts, giving them a more rounded look and creating the illusion of firmer breasts.
• Breast Lift with Implants: In cases of significant sagging, breast implants can be combined with a breast lift (mastopexy) procedure. These surgeries may or may not be completed at different stages to increase the longevity of the final results, but this dual enhancement can remove excess skin and tighten surrounding tissues to provide a more lifted appearance.

The best treatment for you depends on your needs, goals, and anatomic indicators, which is why we advise scheduling a personal consultation with Dr. Schooler so he can listen to your concerns and develop the best surgical plan to help you regain firmer breast contours. These procedures can also be performed as part of a full-on Mommy Makeover to address multiple areas at once, if desired.

Dr. Wesley Schooler offers a myriad of effective solutions to combat the effects of aging on the breasts and restore more youthful contours. Don’t hesitate to contact Santa Barbara Plastic Surgery Center today for more information on our breast surgery options, or to book a consultation.

Large breasts can pose significant issues for patients burdened by the stressors of a heavy, dominating breast size. On top of aching pain in the shoulders, neck, and back, excessively large breasts can also cause skin chafing and “shoulder-grooving” — which refers to uncomfortable bra strap indentations in the skin. In light of the aesthetic and functional concerns often associated with overly large breasts, many women wonder whether dieting, exercise, or other natural remedies are capable of reducing the weight of the breasts. Unfortunately, a healthy lifestyle isn’t enough to alleviate the problems caused by a disproportionately heavy breast size. 

While dieting and exercise may help shed excess weight, working out does not affect the stubborn fat and glandular tissue that typically contribute to a large bust. Moreover, weight loss does not proportionally reduce the breasts or address skin inelasticity, stretched tissue, and other factors causing pendulousness. In order to effectively improve these concerns, many patients turn to breast reduction — a powerful and transformative procedure designed to reshape the breast contours and alleviate the discomfort of excessive breasts. This surgery can also improve stretched or elongated nipples caused by ptosis, or breast sagging. Breast reduction is the only cosmetic procedure designed to decrease the breast size while providing elegant and proportional results. In fact, most women consider breast reduction to be life-changing — not only by allowing a more youthful, aesthetic look in the breasts, but also by making it easier to live a more active life. In turn, many patients find that they enjoy a healthier lifestyle as an adjunctive benefit of breast reduction surgery. 

Dr. Wesley Schooler is a board-certified plastic surgeon who has provided top-notch results for the Santa Barbara community for decades. Contact Santa Barbara Plastic Surgery Center today to schedule a consultation with Dr. Schooler, or to learn more about our breast procedures. 

“Macromastia” is the medical term for large breasts. While many women are born with large breasts and experience no issues, a significant portion struggle with symptoms caused by the excessive weight of their breast size. These effects can range from minor burdens to debilitating health problems that diminish your quality of life. Some of the most common symptoms of large breasts — sometimes referred to as “breast hypertrophy” — include: 

• Chronic pain in the back, neck, and shoulders
• Grooving in the shoulders
• Chest wall pain
• Headaches
• Poor posture
• Tingling or numbness in the hands and fingertips
• Shortness of breath and labored breathing
• Rashes and skin irritation underneath the breasts
• Reduced capacity to exercise
• Disturbances during sleep

Unfortunately, overly large breasts will not improve on their own and often grow more pendulous (hanging) over time. If you find that a dominating breast size is interfering with your goals or if you simply want lighter and more manageable breasts, our plastic surgeon in Santa Barbara offers breast reduction surgery — a procedure that is widely considered the most powerful solution for a dominating breast size. A breast reduction can successfully make the breasts more proportional to the rest of your body by reducing excess skin, fat, and glandular tissue in the chest. This can greatly improve, or even completely resolve, the painful symptoms caused by excessively large breasts. 

Dr. Wesley Schooler can listen to your concerns and recommend an optimal treatment plan to make your ideal outcome a reality. A breast reduction naturally offers some of the benefits of a breast lift, and our team can help determine the best type of procedure to achieve your goals. Please contact Santa Barbara Center for Plastic Surgery to schedule a consultation or to learn more. 

It’s well-known that the breasts can change in shape, size, and texture as you get older. With age and particularly during menopause, your body produces less estrogen and the skin can simultaneously lose elasticity. These factors — combined with the weakening of internal breast support — commonly result in an array of tissue changes, including:

• A loss of firmness and volume
• A loss of shape, resulting in elongated or flat breasts
• Sagging or drooping breast tissue
• The development of stretch marks
• A wider space between the breasts

The breasts can also change prior to entering menopause due to other life events, such as pregnancy and major weight loss. Fortunately, youthful breast contours can be restored using treatment options designed to reverse the tissue changes caused by aging. Breast augmentation can enhance firmness, volume, and support for the breasts, while mastopexy can reduce sagging and attain a more rejuvenated positioning. Both procedures are often combined into one treatment plan consisting of a breast lift with implants, allowing patients to achieve the best possible result.

Dr. Wesley Schooler can create a personalized treatment plan tailored to make your desired breast contours a reality. To schedule a consultation and learn more about what improvements are possible, please contact Santa Barbara Plastic Surgery Center today.

Survivors of breast cancer receive a number of physical and emotional benefits from breast reconstruction surgery. The procedure can often restore a familiar feminine silhouette, improve confidence, and, in the case of autologous reconstruction, provide natural-looking results that feel authentic.

There are a number of available approaches for autologous reconstruction, and many of them begin by harvesting a flap of tissue used to rebuild the breasts. Comprised of a combination of excess skin and fat tissue, Dr. Wesley Schooler, our board-certified plastic surgeon, utilizes the muscle-sparing DIEP (Deep Inferior Epigastric Perforator) flap sourced from the abdomen. As a free-transforming flap, it is completely separated from the origin tissue. Dr. Schooler prefers this procedure, as it is designed to allow a full return to functionality after healing.

After obtaining the body tissue, Dr. Schooler will reshape and secure it microsurgically to the chest wall. Then, he will reconnect the blood vessels, creating living tissue that moves with the body and feels very natural. Benefits of natural breast reconstruction can include:

• Natural looking and feeling results
• Flatter abdominal appearance
• No surgery on the other breast unless breast lift or breast reduction is requested
• Use of the body’s own tissue
• Typically permanent results—no need for additional surgery

Ultimately, choosing to rebuild the breasts with natural body tissues can help restore a sense of empowerment, but it may not be the most effective technique for every patient. Dr. Schooler can help patients determine which procedure provides the best opportunity for success based on their individual needs and goals during the consultation process.

For more information on autologous reconstruction or any other breast reconstruction technique offered at our practice, or if you wish to schedule a consultation, please contact us today.

It took me a while to decide what I was going to write because there is no way I could thank Dr Buchanan in just one statement! In August of 2014 I had a Breast Reduction and Lift along with Liposuction of the Stomach and Hip areas. It has improved my active lifestyle more than I ever imagined. I work out a lot and these were areas that I had a really hard time improving upon. Every day since surgery, my body seems to get better and better! I have gotten faster in running and improved my golf game. This is by far the most caring and professional doctor’s office I have ever been in. All I can say is having the surgery was the 2nd best decision, Dr Buchanan was the 1st! Thank You!!

Oh, and please tell Dr Buchanan that since the surgery I went from a 32 handicap to a 22. Not too shabby. And that I even broke 90! Thanks again! ~SJ

Patients who have undergone radiation therapy as part of their breast cancer treatment cannot always utilize the same breast reconstruction methods as those who have not. Though irradiated patients should typically delay procedures until treatment is complete, it’s still possible for them to achieve results that are as beautiful and natural-looking as any breast cancer survivor.

A common method for rebuilding breasts post-radiation treatment is autologous reconstruction, which uses the patient’s own body tissue – usually sourced from the abdomen – to rebuild the breasts. With this technique, our breast reconstruction surgeon, Dr. Wesley Schooler, harvests a section of skin and fatty tissue, called a DIEP (Deep Inferior Epigastric Perforator) flap, using muscle-sparing methods and reshapes it to create breast tissue. Once healed, the results are often very natural-looking, and full function of abdominal muscles is typically maintained.

Dr. Schooler offers a second option for patients interested in implant-based reconstruction prior to completing cancer treatments. By combining breast implants with harvested fatty tissue and skin, patients can obtain full, shapely results with reduced risk of complications associated with breast implant procedures traditionally performed on patients requiring radiation.

As with all surgical procedures, Dr. Schooler will discuss the benefits and risks involved with each technique during the consultation process. With his extensive experience in breast reconstruction and emphasis on a quality patient experience, Dr. Schooler can often restore confidence while providing beautiful, natural-looking results patients love.

For more information about breast reconstruction procedures for breast cancer patients who have received radiation, or to schedule a consultation, please contact our office today.

Undergoing breast reconstruction is a significant experience – one which can often help women feel whole and healthy after defeating breast cancer. Following mastectomy, the breasts can be restored utilizing a number of modern techniques. Dr. Wesley Schooler, our board-certified plastic surgeon, will determine which procedure is right based upon expressed wishes and anatomic indications. Ultimately, he strives to provide the most natural-looking results possible.

There are three main approaches to rebuilding the breast mound, and each is dependent upon the unique needs of the patient. Here is a brief overview of the options available for rebuilding the breast mound:

Implant-Based Reconstruction

Much like a breast augmentation, implant-based reconstruction utilizes breast implants to help recreate the shape and volume of natural breast tissue. Tissue expanders are utilized to create a pocket for either a saline or silicone implant, and acellular dermal matrices (sterile frameworks of tissue) are used to increase hardiness of the lower half of the breast. Dr. Schooler emphasizes nipple-sparing methods when combining mastectomy and breast reconstruction; however, with modern techniques it is possible to recreate a nipple lost to mastectomy.

Autologous Reconstruction

In some patients it may be possible to reconstruct the breasts using only natural body tissue. This procedure, known as autologous reconstruction, requires donor skin from another area of the body, such as the abdomen. While necessitating fewer surgeries, autologous reconstruction requires a much longer recovery period. However, it is a popular choice for many patients who do not wish to or cannot have implants as it often offers very natural-looking, natural-feeling results.

Breast Implants Combined with Autologous Reconstruction

A third alternative combines elements of both options: breast implants and natural tissue. With this technique, skin, fat, and muscle is donated – usually from the back, abdomen, or thighs – providing a bed for the implants.

No matter the technique he utilizes, Dr. Schooler’s primary objective for every breast reconstruction is providing results that are as comfortable and natural-looking as possible. If you would like additional information about breast reconstruction procedures, or if you wish to schedule a consultation with Dr. Schooler, please contact us today.