Definition and Overview
A mastopexy, also known simply as a breast lift, is a cosmetic surgical procedure that improves the appearance of the breasts. It effectively boosts the breast's size, improves breast projection, creates a more defined contour, and gives the breasts and the nipples a lift.
In the past, aesthetic improvements made on the body are always accompanied with scars. Nowadays, however, modern surgical techniques have made it possible for a woman to undergo breast surgery without or with very minimal scarring.
Who should undergo and expected results
Women who have sagging or drooping breasts are the best candidates for mastopexy. Regardless of their age, they can undergo this procedure as long as their breasts are already fully developed. The procedure does not affect the normal functions of the breast, which means that those who elect to undergo this procedure can still breastfeed.
A mastopexy is most commonly performed on women who meet the following factors:
- Older age – As a person ages, the skin's elasticity begins to wane. The skin may then be unable to hold the breasts in their original position.
- Post-partum or childbirth – Women who have given birth may experience sagging or drooping due to the way the breasts are stretched during engorgement and breastfeeding.
- Weight gain – If a woman gains a lot of weight, the skin may not be accustomed to the heavier weight of the breasts, thus succumbing to some sagging.
- Drastic weight loss – If a woman loses a lot of weight very quickly, she may be left with some loose, excess skin, causing the breasts to sag.
- Breast gland atrophy - This can be due to many factors, but more commonly occurs in post-menopausal patients.
- Implant removal – Patients who have had implants placed then removed face a higher risk of ptosis due to the sudden reduced size and weight of the breasts, causing the skin to become lax.
The sagging of the breasts, also called in medical terms as ptosis, may affect a woman in varying stages. Ptosis cases are classified into the following grades or degrees:
- Grade 1 Mild Ptosis – This is when the nipple is still above the lower half of the breast but just below the inframammary fold.
- Grade 2 Moderate Ptosis – This is when the lower pole tissue below the nipple reduces and the nipple is already further below the fold.
- Grade 3 Severe ptosis – This means the nipple is already way below the fold and the tissue underneath the nipple has disappeared.
- Grade 4 Pseudoptosis – This is more commonly observed among post-partum women.
After undergoing a breast lift surgery, the patient's breasts may not yet match the patient's desired appearance as the breasts may still be sore, bruised, and swollen. The results of the surgery are noticeable once the stitches are taken out. If the breasts look asymmetrical or the patient is not fully satisfied, surgeons can easily do a minor touch-up procedure and other adjustments.
How the procedure works
While other cosmetic breast surgeries are complex and may require a hospital stay, a mastopexy can be performed on an outpatient basis. Although more commonly performed in the hospital setting, this can also be performed in a cosmetic surgery clinic or a private doctor's operating room. It may take up to three hours, with the patient under general anesthesia and, therefore, asleep the whole time.
However, many women undergo a breast lift in combination with breast implants. If so, the procedure will last longer and the patient will have to remain in the hospital overnight.
Prior to the actual procedure, the surgeon will put marks on the breasts that indicate the desired position of the nipples. The patient then goes on to the operating room and anesthesia is administered.
Since sagging and drooping breasts are caused by excess skin that has lost its flexibility, the surgeon typically removes the extra skin to tighten the breasts and lift them up to a more elevated position. The mastopexy ends here, but if the patient is also getting implants, they will be placed at this point before the surgeon closes the incisions.
The patient may be sent home with tiny drains that are used to drain out excess fluid from the breasts and should be kept in place for around 1 to 2 days. They will be removed during the patient's first follow-up visit, whereas the stitches will be removed after two or three weeks.
Possible risks and complications
Breast lift procedures are generally safe and do not often cause complications. However, as with all surgical operations, the procedure still carries a small risk of bleeding, infection, and scarring. To minimize potential risks, patients are given instructions on how to prepare for the procedure.
Patients who are scheduled to undergo a mastopexy should:
- Refrain from smoking
- Not take any medication that increases the risk of bleeding (such as blood thinners); if the patient requires medications for an ongoing health issue, the surgeon will re-evaluate her condition to check whether it is safe for her to proceed with the procedure
Patients who have undergone the procedure will also be given post-operative instructions to help prevent negative post-surgical reactions. Patients are usually placed on antibiotics to reduce the risk of wound infection and are prohibited from engaging in strenuous activities for at least six weeks after the procedure. They are also advised to return to the surgeon's office for a follow-up a couple of days after the procedure.
It is normal and unavoidable, however, for patients to experience some pain and discomfort after undergoing a breast lift. As such, it is typical for surgeons to prescribe some pain medications or a special dressing for the breasts to protect them as they heal.
- Higdon KK, Grotting JC. Mastopexy. In: Neligan PC, ed. Plastic Surgery. 3rd ed. Philadelphia, PA: Elsevier; 2013:chap 7.