Mastopexy or Breast Lift

Mastopexy or breast lift creates a perkier, lifted, more youthful breast shape. Your mastopexy result should look natural, like you have simply turned back time. 

Mastopexy or breast uplift is a cosmetic procedure that improves the shape of the breasts. It can be done combined with a breast reduction or in combination with a breast augmentation. Ptosis of the breasts (breast droop, breast deflation) can occur after pregnancy, significant weight loss or as part of the natural aging process. A mastopexy reshapes the breast by rearranging the breast tissue, re-draping loose breast skin, and lifting the breast tissue back up to its youthful position on the chest wall. The nipple and areola are lifted as part of the procedure to a position where they are forward facing and sitting on the point of maximum projection of the breast.

Mastopexy or breast lift creates a perkier, lifted, more youthful breast shape. Your mastopexy result should look natural, like you have simply turned back time. Many ladies who have mastopexy describe improved body image and self-confidence.

The ptotic or droopy breast usually has three issues that need to be addressed; 

  1. the breast tissue has lost its shape and hangs low on the chest;
  2. the nipple and areola are low on the breast, often pointing downward; 
  3. there is excess empty breast skin.

Mastopexy addresses these three intimately related components by reshaping the breast tissue, repositioning the nipple, and removing and re-draping extra skin. In cases of enlarged nipple / areola complex, they can be also be reduced to be more proportional to the breast.

A mastopexy will rejuvenate drooping / sagging breasts to an elevated and more youthful position, but does not increase the breast volume. Sometimes, if you have lost breast volume a breast implant is required at the same time mastopexy to achieve a fuller, enhanced breast with more projection. See my Mastopexy-Augmentation section for further details.

Who Is It Suitable For?

Mastopexy is suitable for women looking to rejuvenate their breasts and improve the contour often following pregnancy or weight loss. You should be physically fit, free from significant health problems and at a healthy weight that is stable prior to embarking on mastopexy surgery.

Who Is It Not Suitable For?

Ladies with significant medical history, smokers and unrealistic expectations are not suitable for Mastopexy. Cosmetic surgery is not suitable for ladies who have been encouraged by others to change their appearance.

What Are the Scars Like?

Every breast lift technique creates a circular incision around the nipple / areola. This allows the nipple to be repositioned on the breast and the areolar diameter to be reduced if necessary. Structures leading to the nipple including nerves, blood vessels and milk ducts are preserved in a breast lift. The remaining incisions are dependant upon your breasts, their shape, your skin quality and your expectations. A personalised surgical plan based on your individual anatomy will be discussed with you once you have been clinically assessed. In general the types of incisions that may be used are discussed below.

Inverted T Technique

The most common procedure for a breast lift involves an incision around the nipple and areola, a vertical incision from the bottom of the areola down to the inframammary fold (IMF), and a short scar that lies within the IMF. These incisions are shorter than the traditional anchor scar that is commonly described, more like a champagne glass than an anchor!

The inverted T technique allows a three-dimensional reshaping of the breast and often produces the most perky breast shape. The nipple / areola are moved on a piece of breast tissue that carries blood vessels, nerves and ducts to them. Maintaining these structures helps to preserve nipple function after surgery.

The inframammary scar is hidden when viewing the breasts from above or from the front and is concealed in bras and bikinis. It is usually only visible when the breasts are lifted. The vertical incision generally fades to be virtually imperceptible, and the areolar scar lies at the natural junction of the pigmented areola and surrounding breast skin and therefore usually blends in.

Vertical Scar (Lollipop Scar)

If you have little excess skin and the nipple only needs lifting a little, a vertical scar technique can be used. This creates a scar around the nipple and vertically down the breast without the horizontal component. Like in the inverted T the blood supply, nerve supply and ducts of the nipple are maintained. The benefits of this technique are the reduced scars however it is not appropriate for cases where there is more excess and a reduction of the breast envelope is required.

Periareolar Technique

In a few cases, a very subtle lift of the nipple is needed for one or both breasts. The periareolar technique uses an incision around the areola (the pigmented circle surrounding the nipple). This technique does not address excess skin or allow major reshaping of the breast. However, a small periareolar lift can be added to a breast augmentation when the nipple requires minor repositioning.

What to expect at Initial Consultation

At your initial consultation I will spend time to get to know you personally, understand your lifestyle and take a full medical history. As a woman and a Plastic Surgeon, I intimately understand how your feelings about your breasts can influence body confidence, self-image and femininity. I aim to give you the result you are looking for and to do this I really need to understand your likes, dislikes and expectations. It is important that you are open and honest at this stage so that I can appreciate your reasons for seeking a breast lift and your expectations for the outcome. I will then examine your breasts, and if you are an appropriate candidate for this surgery, your options will be described in detail. Where I feel an alternative surgery will better achieve what you have described this will also be fully explained. Whatever we decide you will be given full details of the type of surgery, its risks and limitations. I always see you for a second consultation prior to booking surgery to ensure that you have had time to fully digest the options and information I have given you.

Preparing for Mastopexy

You should be physically fit and at your ideal weight which should be stable prior to embarking on Mastopexy. Your health will be assessed pre-operatively and you may need some tests that will be arranged if required. You should stop smoking at least 6 weeks ahead of surgery to reduce the risk of wound healing problems. You should stop aspirin, anti-inflammatory medications and any non-prescribed medication at least a week before surgery. If there is any change in your health prior to your surgery date you should let me know. Your health and general well being are my primary concern when I am treating you therefore if you are unwell for any reason it may be necessary to postpone surgery.

What To Expect on the day of Surgery?

Mastopexy is perfomed under a general anaesthetic as a day case procedure. It usually takes 2-3 hours depending on the patient. An incision is made as per your individualised treatment plan, excess skin is removed, the nipple is lifted and the breast tissue rearranged. The wounds are closed with dissolvable stitches and I do not usually use drains. You will be back on the ward around an hour after the procedure and able to go home later that same day.

In some patients liposuction is added to a mastopexy to help shape the outer of the breast, providing a better contour, and reducing the “axillary roll” (armpit fat) and back roll regions which may otherwise compromise the aesthetic result. We will have decided together pre-operatively whether this is something that you need to achieve your desired outcome so it won’t come as a surprise. When you have liposuction you may be bruised in the area for several weeks post-op.

What to Expect After Surgery

You should arrange for someone to pick you up following surgery and have someone to stay with you overnight. For the first few days you will need some support at home. In the initial post-operative period you will feel swollen and will have some discomfort requiring analgesia. You will be asked to wear a supportive post-op bra immediately and for six weeks day and night. You should keep the wounds dry until your first dressing change at one week.. You should avoid any strenuous exercise in the first week and should continue to wear a support bra for 6 weeks after surgery. You will be able to start light exercises after a week and normal exercise by 2-3 weeks provided you have a supportive bra. You should begin massage to the scar once healed, a simple moisturiser can be used for massage. Bruising and swelling last for a few weeks and redness and discharge may occur. The two breasts often settle down at different rates so you may notice some asymmetry in the initial weeks. It can take many months to years for the scars to fade.

What are the Potential Complications of Mastopexy Surgery?

Early in the post-operative phase you may notice bruising, swelling, altered nipple sensation and a difference between the two sides. All of these are common and most settle down over the first few weeks. Nipple sensation may be either increased or decreased and these changes may persist for a few months or even a year but are rarely permanent.  Any operation under general anaesthetic carries risks of DVT, PE and cardiac or respiratory complications. Complications that are occasionally seen following surgery are haematoma, seroma, infection and delayed healing. Loss of the nipple areola complex has been described but is rare.

In some patients the scars may be red and obvious for some time before fading. In those susceptible to poor scarring thickened sensitive scars may persist for some time following surgery and in some cases require treatment. With time breast tissue continues to age and the recurrence of droopiness will depend upon changes to the body through pregnancy and weight change and the quality of your skin and soft tissues.

Will I be Able to Breast Feed?

All breast procedures should ideally preserve the functions of the breast; breast-feeding and pleasure (sensation). The aim of the mastopexy is to reshape the breast rather than to remove tissue so the underlying structures should remain intact. Therefore the ability to breast-feed should be retained however, some women may be unable to breast-feed even without having breast surgery. 

Will I Need Additional Surgery after a Mastopexy?

Unless you have an augmentation-mastopexy there should be no need for future surgery. However, it is important to remember that mastopexy resets the clock, it does not stop time. Your breasts will continue to age, just like the rest of you however they will be starting from a perky new shape and would normally stay natural-looking and youthful for many years. If you subsequently have variations in weight or if you have very poor quality skin the longevity of the results will be affected. Unlike implants there is no reason to undergo any additional surgery unless you are experiencing a problem or unless you wish to do so.

Implications For Mammograms And Screening

If you are of screening age you should be up to date with screen prior to embarking on surgery. The surgery should not interfere with future mammograms. You need to tell the mammography service that you have had breast surgery although it will not change your management.

Is a Mastopexy Part of a Mummy Makeover?

This very much depends on how pregnancy and breast-feeding has affected your body! Mastopexy is a frequent component of a Mummy Makeover, with or without implants. Please see my Mummy makeover section to learn more about common body changes after pregnancy and how a Mummy Makeover addresses these.

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