Breast LIft (Mastopexy)

Over time, most women’s’ breasts change in shape and begin to sag. The sagging can be made worse by weight shifts and pregnancy. Many women have issues with breast sagging all their lives without any weight or pregnancy issues at all.

Mastopexy, or Breast-Lift, is performed to lift the breast back into a normal position. The breasts stay about the same size, though they can get slightly smaller. No implants are used in these cases, but a mastopexy can be combined with implants. A breast lift can also be combined with fat transfer to give more fill to the lifted breast. There are many types of mastopexy, but they all produce a scar on the breast, so it is vital that patients understand the scar before surgery. The scar can be just around the nipple/areola, or it can be a lollipop shape around the areola and down. Some cases require an anchor-type scar with the lollipop extending under each breast.

What are the different ways breast droop is characterized and classified?

Breast droop is characterized and classified to four general types to aid in formulating the best Breast Lift technique:

Glandular Ptosis Or Pseudoptosis
The breast gland droops down below the inframammary fold, but the nipple-areola is positioned above the crease
Grade I Ptosis
Both the gland and nipple droop slightly below the breast crease
Grade II Ptosis
Gland and nipple droop more significantly below the crease
Grade III Ptosis
The most severe form, associated with the nipple-areola at the lowest aspect of the drooping breast

Why Choose a Breast Lift?

A woman’s breasts may droop as a result of aging and gravity or after pregnancy, breastfeeding, or weight loss. A breast lift (mastopexy) is performed to restore a more youthful shape to breasts that have sagged or lost perkiness by tightening the breast tissue, repositioning the nipples, and redraping the breast skin.

An ideal candidate for a breast lift can be a patient who’s breast shape may have changed due to weight fluctuations, pregnancy, or anyone who has dealt with their breast sagging throughout their lives. They can also be done for anyone who hasn’t dealt with similar experiences and are simply looking to enhance the look of their breasts.

WHAT ARE THE BENEFITS OF A BREAST LIFT?

A breast lift can bring back the perky bounce of your breasts, allowing them to look younger and more attractive and has a number of benefits and desirable results:
Removes excess skin and tightens the surrounding tissue, creating a more youthful look
Reduces the size of the areolas if they have become enlarged over time
Creates a more shapely look
Makes uneven breasts more proportionate
Corrects drooping nipples
Creates more cleavage
Improves body proportions between breast and buttocks
Allows clothing to fit better
Creates more projected breasts

What are some of the factors that determine breast lift type?

In addition to the positional factors listed above, these must all be considered when choosing the best Breast Lift approach:
Breast skin inelasticity
Areolar size
Glandular density
General breast shape
Degree of deflation

What determines incision type?

Breast lift incision choices will vary depending upon the degree of deflation, the breast and nipple position, the elasticity of the skin, and whether or not volume will be restored concomitantly with breast implants.

Mild breast droop

In the mildest forms, a circumareolar mastopexy, with an incision confined to the areola, is appropriate.

Moderate breast droop

In certain cases with more moderate droop where breast implants will also be used, the circumareolar approach may also be appropriate. In situations where the breast droop is moderate and additional shaping, elevation and restoration of projection are required, a circumvertical mastopexy, with a lollipop incision around the areola and a vertical line beneath it, will yield the most pleasing shape.

Severe breast droop

In cases of the most severe breast droop and deflation where the most “lifting” is required, a breast lift that employs a circular incision around the areola, a line progressing vertically to the crease, and a limited incision within the crease may be indicated. In any case, only the shortest incisional approach will be undertaken to achieve the desired results.

Adding volume during a lift

If additional breast volume is desired, particularly in the restoration of the breast upper pole in the region above the nipple that tends to deflate postpartum or after weight loss, a breast lift can be combined with breast augmentation with the simultaneous placement of breast implants to further enhance the breast shape and balance.

Can breast implants be used too?

Breast lift surgery can be performed using native tissues only, or with the addition of volume using breast implants to better restore a more youthful, natural shape.

Risks of Mastopexy

In addition to the risks associated with surgery and anesthesia, those related to augmentation mammaplasty using implants include the following:

A temporary or permanent change in nipple/breast sensation
Damage to the blood supply of the nipple causing nipple death
Irregularities in breast contour/shape which may require additional surgery.
Asymmetry of the breasts. This is usually from an original asymmetry with the breast anatomy prior to surgery which could not be completely corrected.
Scarring – There is always a scar, so patients must understand the risks pre-operatively. Most scars are totally acceptable.

HOW LONG IS THE RECOVERY PERIOD?

The recovery period for a breast lift is generally about a week or so depending on each patient. Patients are made to wear a surgical bra that helps to reduce swelling and support the breasts. Patients may feel sore or exhausted post surgery, but many are able to return to work within a week. Tape can be applied to the breasts and will remain in place for about three weeks, while the stitches dissolve on their own. Pain, swelling, and sensitivity should subside during the first few weeks after surgery.

What Is the Lollipop Incision?

The lollipop breast lift is appropriate for women with mild to moderate breast ptosis. This incision runs around the areola and continues vertically down the lower pole of the breast (from the bottom of the areola to the breast crease where the breast meets the ribcage). This technique results in little post-operative scarring and allows for adjustment to the nipple-areola complex.

What Is the Anchor Incision?

The anchor incision (inverted-T) allows for the most significant amount of ptosis correction. This technique takes the lollipop incision and extends it horizontally across the breast crease. While this process does result in post-operative scarring on the breast, it can tighten and remove the most amount of skin and tissues.
The anchor incision allows for the resizing and repositioning of the nipple-areola complex.

Should I Combine My Breast Lift With Breast Augmentation?

The combination of a breast lift with breast augmentation surgery is common after pregnancy or significant weight loss (and is often performed during a Mommy Makeover). A breast lift restores elevation and projection to breasts that have been augmented with implants or fat transfer. Some women discover that their new implants sag if their breast tissues are not tight. Breast lift surgery eliminates this situation.

Should I Combine My Breast Lift With Breast Reduction?

Breast reduction surgery is almost always combined with a breast lift; however, a breast lift does not have to be performed with breast reduction. A combination of a lift and reduction is only necessary for women with overly large breasts that would have significantly loose skin and sagging tissues after the removal of glandular tissue and fat.

Can I have my nipples reduced during a breast lift?

Areolar reduction is commonly performed with mastopexy or Breast Lift. The final areolar size is chosen to be proportional with the perkier more lifted breast shape and position.

How does a breast lift affect breastfeeding?

Most Breast Lift procedures do not have an effect on one’s ability to breastfeed.

Will I experience decreased sensitivity?

While sensory change is possible, areolar sensitivity decreases are less common after most Breast Lifts.

What Will My Breast Lift Recovery Be Like?

The breast lift is an outpatient procedure, and you will return home shortly after your surgery. You will be recommended to rest for the following two to three days before returning to work. A compression garment/surgical bra will be wrapped around your chest to help promote circulation, reduce swelling, and facilitate the healing process.

Is Breast Lift Surgery Painful?

Breast lift surgery is performed under general anesthesia for your comfort and safety. Any post-operative pain can be lessened with prescribed or over-the-counter pain medication. Most women feel little to no pain after a few days to one week.

Will My Breast Lift Leave Scars?

The severity and location of your breast lift scars will vary by the breast lift incision you chose. These scars can be covered with clothes and bathing suits and will reduce significantly over time. Breast lift scars can be minimized with scar treatments, creams, and silicone strips.

Will my breast lift be permanent?

While the results of your breast lift will last for many years, no surgical procedure can stop the natural aging process. Therefore, you should expect that your breasts will eventually develop some additional sagging and loss of shape. You can help to prolong the quality of your results by maintaining a stable weight and wearing a supportive bra. Breast lift surgery may be repeated if necessary.