With age and pregnancy (particularly if you breast feed), the breast often begins to sag and becomes somewhat deflated looking. Sagging can result in anything from a slight flattening of the upper portion of the breast to a significant loss of breast volume and a downward positioning of the nipple. A mastopexy or breast lift is a procedure which attempts to improve breast sagginess. How much improvement depends on the severity of the problem. A mastopexy can involve anything from removing a small amount skin above the nipple to a large amount of skin and breast tissue around the nipple and under the breast.

About the Procedure
I think breast lifts are over-rated and in many cases not worth the resultant scars. You never get as much improvement as you would like. A mastopexy does lift the nipple if the nipple is pointing downward. However, it does not permanently lift the entire breast. Most commonly, I see patients desiring a mastopexy because the breast has begun to slide downward, leaving the upper portion very flat. Quite often the nipple position in these patients is okay. I usually recommend a subglandular (above the pectoralis muscle) implant to fill out the flat upper portion of the breast. This creates the illusion that the breast has been lifted and a mastopexy is usually not necessary. Some patients need both a lift to improve nipple position as well as an implant to improve the fullness of the upper portion of the breast. This makes the patient much fuller but also slightly larger in cup size.

Types of Mastopexy
Depending on how much the breast sags, mastopexy can involve anything from simply removing a small amount of skin around the nipple to removing large amounts of skin and/or breast tissue underneath the breast and around the nipple. The more tissue removed, the larger the scars. The removal of a small amount of breast tissue with breast skin will allows the breast to be lifted more than with just skin removal because some of the weight of the breast has been removed.

This is essentially a small breast reduction and the scars are larger. This procedure does leave the patient with slightly smaller breasts but the breast has been lifted higher than with a skin lift only. A small implant can be used to make up for the size decrease and provide increased fullness. Patients desiring maximum lift and large breasts often require a staged procedure with full mastopexy followed by augmentation several months later.

Complications
Scarring – The biggest drawback of the procedure, unacceptable to many patients because of their location around the nipple, vertically down from the nipple and under the breast. The scars fade in time, but tend to be wide scars and are still visible.

Asymmetry – Small differences in shape or size of the breasts are not uncommon following mastopexy. No patient will have mirror image breasts following surgery.

Alteration in Nipple Sensation – Most patients will have some change in nipple sensation following mastopexy. Any change in sensation is usually temporary but could take weeks to months to return.

For more information about Breast Lifts and to view a Breast Lift procedure in 3D, visit the American Society of Plastic Surgeons website by clicking here.