BREAST LIFT (Mastopexy)

Sagging breast is a disturbing condition for women that can be due to aging, weight loss the effect of gravity and post pregnancy and lactation changes. The breast appears droopy and less full with flatness at the upper portion. Women with saggy breasts often have reduced elasticity in their skin and may have stretch marks.

The degree of sagginess in the breast is measured by the relationship of the nipple and areola to the crease beneath the breast (the inframammary fold). The surgical treatment for sagging breasts may vary based on the nipple-areola position, breast volume and excess skin. For minimal laxity the correction may be a simple breast augmentation to restore the volume and fullness to the breast and also raise the nipple-areola complex. For more significant laxity a breast lift procedure with removal of skin is necessary and some times may be combined with breast augmentation.

A mastopexy, which is a medical term for a breast lift, is a procedure where we tailor the skin of the breast to elevate it. The saggier the breast the more skin needs to be removed for correction. Although by definition any type of breast involves incision and scars on the breast, the improvement in shape usually represents a satisfactory trade off. There are four main types of lifts that are usually named based on the resulting scar:

  1. A donut lift- is a lift which involves removal of skin around the areola (brown part of the nipple) and therefore results in elevation of the nipple areola. The scarring is usually minimal and it allows downsizing of the areola which is usually stretched with the rest of the breast skin. If a large amount of skin is removed around the areola a special purse string suture is placed around the incision to allow proper healing with minimal scarring. This special suture may result in some bunching of skin that usually resolves spontaneously with time.
  2. A lollipop lift- Also called the vertical mastopexy involves removal of skin around the areola and the lower portion of the breast. This results in a scar around the areola combined with a vertical scar at the lower portion of the breast. In women with large breasts a small portion of the breast tissue may be removed and internal sutures placed to achieve more fullness.
  3. A J type lift- involves removal of skin around the areola and at the inferior portion of the breast. It is essentially like the lollipop lift with an additional ellipse of skin removed to one side of the fold under the breast. We use this lift very commonly since it gives the patients more fullness at the cleavage area with less scarring than the inverted T lift.
  4. Inverted T lift- this also involves removal of skin around the areola and the inferior portion of the breast. It is also called the anchor lift since skin is removed from both sides of the fold underneath the breast.

We often combine breast lift with a breast augmentation to achieve more fullness in the upper portion of the breast. Since the lift and the augmentation are two negating forces (the lift is pulling the breast up and the implant is pushing the breast back down) we encourage our patients to be very conservative with the implant size. Since the cause of saggy breasts is poor skin elasticity adding more weight to the breast may cause them to sag again at a faster rate. Therefore, postoperative support with a bra is essential to maintaining a breast lift result. In addition, women that are large breasted will benefit more from a breast reduction rather than a lift.