Breast Lift (Mastopexy)

Breast Lift Surgery (Mastopexy)

View Before & After PhotosThere are many factors that may contribute to sagging of the breasts, also known as breast ptosis. Breasts may droop due to aging, genetic predisposition, weight gain, puberty, pregnancy, and as a consequence of nursing/breast feeding. With time, the breast tissue may be replaced with fatty tissue (adipose) and the skin may become looser as the stronger components of the skin are slowly lost during the aging process or as the skin stretches out as seen during pregnancy, etc. When the elasticity of the skin is lost, the skin will no longer remain tight, and consequently, the breast may begin to droop or sag. If the gland of the breast descends below the nipple, resulting in a flattened appearance or loss of fullness in the upper part of the breast, this is referred to as pseudoptosis or glandular ptosis. This is different than true ptosis since the nipple is above of the crease below the breast (inframammary fold).

Pseudoptosis can usually be corrected by replacing the lost volume simply with a breast implant. This will restore the fullness in the upper pole of the breast (above the nipple). True ptosis is corrected with a breast lift. There are several different types of lifts (mastopexy) that can be performed depending on the degree of sagging/drooping. Sagging or drooping is graded on a scale of 1 (mild) to 4 (severe). The more severe sagging will require more complex surgery to obtain an aesthetic result.

There are many different types of breast lifts that have been proposed over the years. Breast lift surgery can be divided into 3 basic types: ones that just go around the nipple (periareolar or Benelli), ones that go around the nipple and then extend down to the crease under the breast (vertical or “lollipop”), and ones that include an incision in the crease under the breast in addition to the “lollipop” incisions (inverted-T or Wise Pattern).

For patients with a mild to moderate amount of sagging/ptosis, a Benelli or crescent-type breast lift may be performed. A small amount of skin is removed from above and/or around the areola. The nipple and areola are lifted upward, the incision is closed as a circle to help hide the incision.

The vertical breast or “lollipop” breast lift incorporates the periareolar incision and a vertical incision below the areola. This lift is generally used for patients that have a mild to moderate amount of sagging. For patients with moderate and severe ptosis, the Wise Pattern or inverted-T breast lift is typically used. This enables the breast mound to be reshaped and the skin to be tightened both vertically as well as horizontally.