The breast lift (mastopexy) is an increasingly popular procedure for women who want to restore their breasts to a more youthful position and appearance. According to statistics collected by the American Society of Plastic Surgeons, the number of mastopexy procedures performed annually in the U.S. has risen 70 percent between 2000 and 2010. This is one of the most commonly requested surgeries as part of a “Mommy Makeover” — a set of cosmetic procedures that help women regain their pre-pregnancy figure.
Why Do Women Seek a Breast Lift?
Aging, breastfeeding, and having large breasts are all factors that can make breasts droop (a condition called “ptosis”). Fluctuation in breast size from pregnancy or weight gain followed by weight loss can also leave breasts sagging. Hormonal shifts and other metabolic changes that occur as a natural part of getting older impact the connective tissue that helps keep breasts firm and high. Laxity of the skin and underlying tissue and loss of volume in the breast combine to make breasts sag.
Women who feel dissatisfied with the shape and position of their breasts are likely to choose a breast lift to create a more attractive silhouette. Often, these patients ask for a mastopexy so the apparent age of their breasts will match the rest of their body or make them look younger overall. Women of any age may also request a breast lift if they have large breasts that are drooping because of their size. Many women turn to a breast lift to position their nipples more attractively (especially if their nipples are angling downward or are located low on the breast). Another reason to request a lift is to reduce the amount of skin on the underside of the breast that touches the skin on the torso. This moist skin fold may tend to harbor fungus that can lead to a persistent rash.
Who is a Good Candidate for a Breast Lift?
Women who are in good physical condition and who are maintaining their desired body weight are the best candidates for this procedure. Ideally, they should have a medical history free of serious, chronic health problems that could increase the risks of surgery. Lifestyle also makes a difference since patients who smoke have a higher chance of poor healing. Patients should have realistic ideas about the short and long term outcomes for this surgery. Future fluctuations in weight including subsequent pregnancies can impact the results. If you plan to have more children, you may want to wait to have this procedure until you are finished building your family. Aging will continue to affect breast tissue and may well cause some recurrence in drooping over the years.
Breast Lift Procedure Choices
One of the most common choices women make about their mastopexy is whether to combine it with another procedure. For example, you might want to have implants inserted since a lift alone does not restore lost volume. These implants may be placed under the soft tissue of the breast or under the chest muscle. Or, if you have large breasts, you may want a reduction as part of the lift. If your breasts are asymmetrical, you might choose a combination of augmentation or reduction along with this surgery to even out your breasts as well as bringing both into the same position. You will also need to decide whether the size and shape of your areolae should be changed.
Beyond this, you may be presented with several incision options based on the size of your breasts, how much they are sagging, and whether you want implants. Here are three of the most common incision patterns:
Anchor or Inverted T — This is the traditional breast lift incision pattern. It goes around the areola, down the center of the bottom side of the breast, and along the breast crease. This approach allows the surgeon to remove skin horizontally and vertically for maximum lifting. An implant can easily be inserted during this procedure. It is often recommended for women with lots of excess skin that is contributing to ptosis.
Vertical — This incision goes from around the areola down the underside of the breast, but it stops at the crease. It is a less invasive approach than the anchor incision and can provide good results for women with moderate skin laxity and drooping. The ease of placing an implant will depend on the type of implant and the size of the incision.
Circumareolar — Women who have small breasts and little skin laxity may have an incision that is restricted to the area around the areola. Inserting a saline implant may be possible, but putting in a silicone implant usually requires a larger incision.
Breast Lift Procedure Overview
This procedure is usually performed under general anesthesia (although other sedation/anesthetic options are sometimes available). The surgeon makes the incisions, repositions the underlying breast tissue into the desired position, and places sutures deep in the tissue to hold everything in place. The surgeon also removes any excess skin to create a firmer, smoother breast. The incisions are sutured closed and may be fitted with small draining tubes to allow fluid to escape. These will usually be taken out after a couple of days. Exterior stitches generally come out after about a week.
What to Expect During Recovery
Swelling, tenderness, bruising, and discomfort are all typical (but temporary) aftereffects of mastopexy surgery. You should notice a significant difference in how your breasts look right away. The incision areas will be red for a while; but the scars should eventually fade and become less noticeable. You will need to return to daily activities gradually as you heal based on your plastic surgeon’s advice. This is especially