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Most surgeons use a formula based on the degree of ptosis the breasts have before advising the amount of incisions needed or whether or not implants are recommended as well as size. To determine the degree of ptosis (sagging), the surgeon looks at the following:  The location of the breast tissue of the chest wall  The location of the nipple and areola in relation to the crease  Location of the glands relative to the crease  The size of the areola  The amount of skin above to the areola  The amount of skin from the areola to the crease  The degree of breast constriction and lack of fullness with a downward facing nipple and areola Knowing these factors helps the surgeon determine how to proceed with the augmentation or lift. Depending on the degree of ptosis, only a few minor incisions may be needed, leaving smaller scars. But for a major lift, several incisions may be needed and scarring becomes the focus. Many women want to be able to show off their breasts as they see fit and would prefer not to have unsightly scars in the line of sight. I don't blame them. Depending on what needs to be done, two surgeries may be needed for both a lift and augmentation, but sometimes the same incisions can be used. The saggier the breast and/or the size of the implant desired, and then more incisions will probably be needed. Can A Massage Help Sagging Breasts? I know some men who would sign up for this! But seriously, breast massages can be tricky due to the fact that breast tissue is quite delicate. But if it's done properly with a moderate amount of pressure, then a breast massage may be helpful. Massaging the breasts can help to make them firmer and healthier, and can also aid in maintaining the balance of hormones in a woman's body. 22