A breast lift is a surgical procedure that elevates the position of the breasts. This surgery is designed to lift sagging breasts to a more youthful, aesthetic position upon the chest.
The vast majority of women cite breast sagging as the main reason why they dislike the appearance of their breasts. Sagging can occur at any age, and once it happens, no amount of exercise will firm the skin or raise breast position. A breast lift (mastopexy) is the only way to treat flat, drooping breasts. During mastopexy, your surgeon removes excess skin and raises areolas so they sit higher on the chest. This process reshapes the breasts, making them rounder, firmer, and pert.
Breasts may sag for many reasons. Some women are genetically predisposed to develop breasts that are more oblong than round. Women also frequently notice sagging breasts due to the effects of pregnancy or weight gain. Both of these factors can cause the breasts to grow by two or more cup sizes; when breasts then lose the volume from weight loss, stretched skin remains, making the breasts look deflated. Mastopexy is, therefore, a core part of mommy makeover surgery or for patients who have sagging breasts and have not been pregnant. Certain lifestyle habits, like exercising without proper breast support, smoking, and tanning can also prematurely age breast tissue and may also contribute to sagging.
In mature women, breast sagging arises due to changes in estrogen and collagen levels. When estrogen levels drop following menopause, breast volume decreases, particularly in the upper portion. As a result, the breasts begin to look flat on top. Compounding this issue, gradual changes to connective tissue deprive the breasts of their natural support. Bands of tissue called Cooper’s ligaments that help breasts maintain their shape slowly stretch out due to the combined effects of gravity and collagen depletion. Women with large, heavy breasts may notice the effects of this stretching as early as their mid-twenties.
Women best suited for a breast lift procedure:
- Sagging or loss of volume in the breasts
- Stable weight
- Good overall health
- Realistic expectations
The goal of a breast lift is to position your breasts higher up on your chest wall and reduce the amount of skin that rests on your upper abdominal wall.
A breast lift is more complex than simply “pinning” your breasts higher as your surgeon needs to move all of your tissue, remove the excess, and ensure that your breasts retain their new positions. To do this, he uses one of several techniques.
Ultimately, which operation the patient chooses will depend mainly on personal goals. Patients undergoing the combination breast augmentation/lifting surgery should understand that there are limits as to how large of a breast implant can be used during this procedure. The breast augmentation surgery is expanding the breast skin “envelope” while breast lifting is (by definition) tightening up the breast skin envelope by removing skin. These 2 forces are counteract each other.
It becomes important to remove the appropriate amount of breast skin and to use the appropriate size/profile of breast implants to balance these 2 forces appropriately to achieve of the patient’s goals as closely as possible while minimizing risks of complications of the procedure.
Mastopexy is a highly adaptable procedure that can be used to correct any grade of skin laxity, from mild to severe. Breast lift surgery is also frequently used to make the breasts more even, reduce the size of disproportionately large areolas, and can be performed in conjunction with correction of inverted nipples, or reduction of excess nipple projection.
However, mastopexy does not increase the size of the breasts. Women who wish to correct any of the issues above while increasing volume can elect to have a combined breast lift and breast augmentation surgery. Performing both of these procedures at the same time shortens the patient’s total recovery period and lowers the overall cost of surgery. On its own, mastopexy decreases the size of the breasts slightly. For a significant decrease in breast volume, patients must have a true breast reduction surgery.
To treat mild breast sagging, our doctors use either the crescent lift or peri-areolar lift (donut technique). With the crescent lift, he makes an incision around the upper half of each of the patient’s areolas, removes a small amount of excess skin, and lifts the areolas. When using the peri-areolar technique, he makes an incision around the entire circumference of each of the patient’s areolas. This allows him to remove more excess skin and reduce the size of the areolas if desired. Both the crescent and peri-areolar techniques have the advantage of producing little visible scar tissue. After the patient’s scars fade, they will usually be disguised by the ring of lighter tissue that naturally surrounds the areola.
To treat moderate to severe drooping, our surgeons use the vertical lift or the anchor lift technique. During a vertical lift, a second incision is made down the lower half of each breast to facilitate the removal of a significant portion of skin. An anchor lift is similar to a vertical lift, but it involves the placement of additional incision, which your surgeon hides in the inframammary fold. Anchor lifts are usually reserved for use on larger-breasted women, who typically require more extensive breast reshaping to achieve a rounded, perky look.
A Donut Lift (Benelli Breast Lift)
UThe donut or Benelli breast lift procedure is a unique surgical procedure that is designed to give breasts a more youthful and lifted appearance. The process involves minor shaping and requires only minimal incision lines. The procedure is for women who need a moderate amount of surgical correction. The donut breast lift procedure involves a surgical incision in a ring around the breast’s areola, allowing for maximum flexibility and for the breast to adapt while maintaining as small an incision as possible.
The donut / Benelli breast lift is often requested by patients who understand the results of the procedure and are satisfied with the minimally-invasive incision around the areola. When considering limited access and flexibility of the procedure, this is an option for only some patients. Your surgeon will review options at the time of initial consultation.
The lollipop breast lift procedure is a unique surgical procedure that is designed to give breasts a more youthful appearance. The process involves minor shaping and requires only minimal incision lines. The procedure is for women who need a moderate amount of surgical correction. The lollipop breast lift procedure involves a surgical incision in a ring around the breast’s areola, along with a straight incision going from the bottom of the areola to the middle of the breast crease, allowing for maximum flexibility and for the breast to adapt while maintaining as small an incision as possible.
The anchor breast lift procedure is a unique surgical procedure that is designed to give breasts a more youthful and lifted appearance. The procedure is for women who need a moderate amount of surgical correction. The anchor breast lift procedure involves a surgical incision in a ring around the breast’s areola, along with a straight incision going from the bottom of the areola to the middle of the breast crease and an extension of the incision to the left and right underneath the breast crease, allowing for maximum flexibility and for the breast to adapt while maintaining as small an incision as possible.
The anchor breast lift is often requested by patients who understand the results of the procedure and are satisfied with the small vertical line down the bottom of the breast. For smaller adjustments, the Benelli lift may be completed instead which involves only an incision around the areola. When considering limited access and flexibility of the procedure, this is an option for only some patients
Your doctor chooses the best surgical technique for your unique anatomy and goals and discusses your options with you before your breast reduction and lift.
Though the results of breast lift surgery vary from patient to patient, the vast majority of women report being highly satisfied with their mastopexy. According to the American Society of Plastic Surgeons (ASPS), breast lift surgery has an overall patient satisfaction rate of 96%. Furthermore, 93% of women said that their confidence was improved following breast lift surgery.
The changes in breast shape created by mastopexy are generally permanent. However, patients who have this procedure at a young age may notice some natural breast sagging later in life. Revision surgery can be provided to enhance the results of your initial procedure if this occurs. Patients are also advised to wait until they are done having children and losing weight before they have breast lift surgery. Pregnancy and weight loss can create additional loose skin and compromise the results of your mastopexy. If you plan on future pregnancies after your procedure, inform your surgeon of your plans.
Breast Lift Variations
Based on your concerns, preferred outcome, and individual anatomy (breast size, shape, and extent of tissue elasticity), your surgeon will use the shortest incisions that will help accomplish the desired result. Utilizing a minimal incision when there is significant amount of laxity is fraught with significant problems. The following are the options for improvement, which may be performed alone or in conjunction with a breast implant augmentation:
- “Crescent Lift”: For very mild degrees of descent of the areola or to improve a small amount of nipple/areolar position asymmetry, only a crescent shaped incision placed at the top of the pigmented portion may be all that is necessary. This is often done in conjunction with the insertion of a breast implant.
- “Doughnut Mastopexy”: A modest amount of laxity requires a greater amount of lifting which in some patients may be nicely improved with a circular incision around the areola (leaving the nipple attached to the underlying tissue).
- ”Lollipop Mastopexy”: If greater lifting is required and more loose skin has to be removed, then there will also be a need for a vertical scar extending downward from the nipple-areola resulting in a scar that will be a circle around the edge of the areola with a line downward to the infra-mammary fold.
- “Anchor Mastopexy”: When the breast relaxation is more severe, there may also be a horizontal scar from side-to-side under the breast, so the scar will be a circle with a line down and then a curved line under the breast.
If you’re not satisfied with the appearance of your breasts, your doctor can help you choose the right treatments to meet your cosmetic goals. Call our plastic surgery center at 858-455-0290 to arrange your consultation.
We look forward to helping you feel more confident and comfortable in our personalized, compassionate surgical care.
Possible Risks and Complications
- Asymmetry: Almost everyone’s breasts are different to begin with and your surgeon will do his best to make them as symmetric as possible — we can never guarantee that they will be perfect.
- Bleeding: It is possible, though unusual to experience a bleeding episode during or after surgery. If post-operative bleeding does occur, it may require emergency treatment to drain accumulated blood. It is important after surgery, especially in the first 2 weeks, to avoid exercise and raising your heart rate and blood pressure. Also avoid aspirin, ibuprofen and many other medications that may affect your ability to clot your blood.
- Loss of Blood Supply to the Nipple-Areola Complex: Limited incision techniques are used, however because of the invasive incisions and relocation of the nipple/areola complex a blood compromise can occur.
- Mal-Positiong of the Nipple – Areola Complex: Depending on implant placement after surgery, the nipple – areola complex may not be in the ideal location and further surgery may be necessary.
- Tissue Necrosis: If a lack of oxygen to the tissue is present after surgery, the tissue will turn purple or blue and if prolonged, tissue damage will occur.
- Infection: This is very rare but can be taken care of with antibiotics if it occurs.
- Loss of nipple/areola sensation: Numbness may occur temporarily or permanently from traumatizing sensory nerves in the breast during the procedure.
- Inability to breast feed: This is not exact because some patients cannot breast feed prior to the surgery.
- Inability to predict exact cup size: We will discuss your goals and do our best to achieve them.
- Breast Asymmetry: The breasts will be “sisters not twins” and symmetry is never promised. Breasts are asymmetrical before surgery and will most likely be asymmetrical following surgery. Differences in terms of breast and nipple shape, size, or symmetry may also occur after surgery.
- Delayed Healing: Wound disruption or delayed healing is possible. Some areas of the breast skin or nipple region may not heal normally and may take a long time to heal. Areas of skin or nipple tissue die. This may require frequent dressing changes or further surgery to remove the non–healed tissue. Smokers have a greater risk of skin loss and wound healing.
- Spreading of the Areola / Scar: All surgery leaves scars, some more visible than others. Abnormal scars may occur within the skin and deeper tissues and may be unattractive and/or a different color than the surrounding tissue. Spreading of the areola may also occur.
- Need for Revisionary surgery: It is possible that you will need to have one or more re-operations over the course of your life because of local complications from breast implants. Reasons for re-operations could include any of the potential
Recovery time depends on the individual and the extent of the procedure, but usually follows a general pattern. The first few days are the most uncomfortable, but pain and discomfort can easily be controlled with prescribed medications and will soon decrease. Bruising and swelling may persist for several weeks. The results will continue to improve for up to one year. The discomfort is initially greater if an implant is placed behind the chest muscle (pectoralis) at the time of the breast lift.
While most patients can begin their return to daily activities (such as driving, light housework, a desk job, and shopping) within 1-2 weeks, you should refrain from exercise, strenuous activity, and heavy lifting for the first 3 weeks.
The results of a breast lift vary depending on each individual patient. Most patients enjoy firmer, more youthful breasts for years, but certain factors, such as aging, weight gain/loss, pregnancy, and gravity can cause the tissues to weaken and the breasts to sag again.
A breast lift is often performed in conjunction with other procedures, such as breast augmentation, breast reduction, body contouring.
There is no way of determining if you will be able to breastfeed after a breast lift. Some women cannot breastfeed regardless of whether or not they had breast surgery.
While a breast lift provides an effective lifting and firming of the breasts that may last for many years, certain factors, such as aging, weight gain/loss, pregnancy, and gravity can cause the tissues to weaken and the breasts to sag again, at which time you may choose to undergo another breast lift.
As with any surgical procedure, complications from a breast lift may occur, but are unlikely. Some of the risks and side effects associated with breast lift surgery include infection, negative reaction to anesthesia, delayed healing, bleeding, prominent scarring, uneven nipples, decreased breast sensation, and breast asymmetry. Every effort is made to make the procedure as safe as possible and limit the risks of problems and complications. Choosing a certified and experienced plastic surgeon and following all instructions will increase the likelihood of having a safe and successful procedure.
Unfortunately you cannot achieve a breast lift without an incision. Any time you make an incision, there is a scar. Scarring is noticeable with breast lift surgery, but fades with time. Your doctor will use the shortest incisions that will accomplish the desired result. The incisions are placed in areas that can be concealed while wearing a bra or bathing suit. Most patients report that the results of cosmetically improved breast shape and position are well worth the scars.
In general, exercise is good for the mind and body and can increase muscle bulk, which can make skin look a little tighter, but exercise cannot actually tighten the breast skin or lift the breasts. Currently, only surgery can effectively and reliably accomplish that.
The procedure can take one to three hours to complete, depending on the method being used.
Usually the procedure is performed as an outpatient in Prime Plastic Surgery, an American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) fully accredited office-base surgical facility.
By lifting and firming up the breasts, a breast lift (mastopexy) may make them look firmer, but generally not larger. In patients who desire fuller breasts, implants can be inserted at the same time, which will make them larger.
AtPrime Plastic Surgery, breast lifts are usually performed under general anesthesia, which is administered and monitored by a board certified anesthesiologist. This means that you are asleep and comfortable through the entire procedure. There are variations as to how this procedure can be performed. Typically the procedure includes: Excess breast skin is removed, the areola is repositioned to a higher position, the underlying loose tissue is contoured, and the incisions are meticulously closed in layers with sutures. If breast volume has decreased, breast implants may be placed to enhance the size and shape of the breasts.