Background:

Loss of skin elasticity, gravity and other factors such as weight loss, pregnancy and breast feeding ultimately affect the shape and firmness of a woman’s breasts. Breast lift surgery, also called mastopexy, removes excess breast skin to raise, reshape and firm breasts. The nipples and areolas (the pigmented skin surrounding the nipples) are repositioned, and the areolas sometimes may be reduced in size. If desired, implants may be inserted in conjunction with a breast lift to increase breast volume. A breast lift can be performed at any age, but plastic surgeons usually recommend waiting until breast development has stopped.

Technique:

Individual factors and personal preferences will determine the specific breast lift technique. A common method of lifting the breasts involves three incisions. One incision is made around the areola. Another runs vertically from the bottom edge of the areola to the crease underneath the breast. The third incision is horizontal beneath the breast and follows the natural curve of the breast crease. After the plastic surgeon has removed excess breast skin, the nipple and areola are shifted to a higher position. The areola, which in a sagging breast may have been stretched, can be reduced in size. Skin that was formerly located above the areola is brought down and together beneath it to reshape the breast. The nipples and areolas remain attached to underlying mounds of tissue, and this usually allows for the preservation of sensation and the ability to breast-feed. In some instances, it may be possible to avoid the horizontal incision beneath the breast, as well as the vertical incision that runs from the bottom edge of the areola to the breast crease. Some patients are good candidates for this limited scar technique.

Benefits:

• Breasts are firmer and more uplifted. The position of the areolas and nipples is enhanced. Data has shown the procedure can also have a positive psychological effect.


• Significant complications from breast lifts are infrequent.


• Unless the patient gains or loses a significant amount of weight or becomes pregnant, breast shape should remain fairly constant.

Other Considerations:

• Every surgical procedure carries risks. Potential complications include reaction to anesthesia, bleeding, infection and poor healing.


• Patient may be instructed to wear a support bra for a few weeks, until the swelling and discoloration of the breasts diminish. Incision lines, which will heal and fade over time, will be permanently visible, although they are in locations easily concealed by clothing.


• Breasts may not be perfectly symmetrical or nipple height may vary slightly. Minor adjustments often can be made at a later time, but patients should remember that natural breasts usually show some variation.


• Permanent loss of sensation in the nipples or areas of breast skin may occur rarely.


• Occasional poor healing of incisions may lead to necessary revision surgery.


• Gravity and the effects of aging will eventually alter the size and shape of every woman’s breast, in which case the patient may choose to undergo a second breast lift procedure.