Breast Lift Surgery

Overview

What is a breast lift?

A breast lift, also known as mastopexy, is a procedure that seeks to perk up sagging breasts, a condition known as ‘breast ptosis.’  Each year, thousands of women undergo breast lift procedures to restore the shape and volume of their breasts for a more youthful breast contour.

Oftentimes breast lifts are combined with other procedures such as breast enlargement or reduction mammaplasty. In cases like these, the breasts are lifted as they are increased or decreased in size. The result are breasts that look and feel better.

Causes of saggy breasts

As women age, their skin loses some of its elasticity and may stretch. Similarly, connective tissue that provides structural support to the breast may stretch. Breast ptosis, or sagging breasts, are a normal part of aging. There are many causes of sagging breasts, some of which include:

• Pregnancy
• Smoking cigarettes
• High body mass
• Genetics
• Running without proper support
• Hormonal changes
• Weight fluctuations
• Gravity

Is surgery right for you?

A good candidate for breast lift surgery typically is someone who is:

• In good overall health and at or near their goal weight
• In general, many women are 18+ years old (younger women typically have breasts that are still developing)
• No major medical issues
• Well informed about how the procedure is performed and potential risks
• Has nipples and areolas that point downward
• Has nipples/ areolae sit below the breast crease
• Has Asymmetrical breasts
• Understands the potential effects on breastfeeding
• Has breasts that are sagging

To determine if you could benefit from a breast lift, place a pen in the crease underneath your breast. If the sagging tissue holds the pen in place without the use of your hands, you could likely benefit from a breast lift.

What to know beforehand

• Pregnancy can undo the results. A breast lift should be done after your family is complete. Pregnancy and major weight fluctuation could alter your results.
• A breast lift won’t change the size of your breasts. The goal of a breast lift is to restore your breasts to their youthful shape and position. You will need to add breast augmentation or reduction surgery to change the size.
• Any significant weight gain or loss can change the size, shape, and perkiness of your breasts. In order to preserve the results of your breast lift, you will need to maintain your weight.
• You’ll have scars, but they should fade over a year or two. In rare cases, poor healing can lead to prominent scars, which can usually be hidden by bras and bathing suits.
• The larger the breast, the more it responds to gravity. A breast lift can significantly improve sagging, but larger breasts will begin to sag as time goes on
• Sagging breasts are normal. Generally only teenage women or pre-partum women with little natural tissue will have little to no droop.

Breast lift procedure

On average, breast lift procedures take one to three hours to perform and require general anesthesia. Sometimes the procedure can take longer if breast implants are inserted.

There are various approaches and incision options for a breast lift. During a consultation your plastic surgeon will recommend the best approach based on your preferences, body shape and degree of ptosis.

Your surgeon will take several factors into consideration while planning your procedure. Significant sagging, large amounts of excess skin, and larger breasts are typically associated with more extensive surgical techniques. Common steps taken during the procedure:

• General anesthesia is administered.
• An incision is made based on the degree of sagging, the amount of excess skin present, and the overall size of the breasts.

All incisions are made according to the contour of the breast so that scarring is hidden and minimal. Here are the different types of incisions:

• • Anchor Incision – This includes one incision around the areola, another along the breast crease horizontally and a third that connects them. This used if there is an extreme degree of sagging. It’s the preferred method if there is also a breast reduction done simultaneously.  The downside of this procedure is that it is the most invasive and will leave the most noticeable scarring.
  • Lollipop Incision – One incision is made around the areola and a second extends vertically to the crease in the breast, resembling a lollipop. This incision is appropriate for women with moderate sagging.
  • Donut Incision – A single incision is made around the areola. This incision is for those who have moderate or mild sagging.
  • Crescent Incision – This incision is only on the upper half of the areola. The procedure is appropriate for those with a small degree of sagging.
  • Scarless breast lift – This is a procedure that lifts and tightens the breast but does not address sagging. It includes tiny incisions that allow a thin tube (a ‘cannula’) to be inserted in order to disrupt fat cells.

• Excess skin is removed.
• The nipple and areola are placed in a higher positioned.
• If breast implants are being used, they will be inserted through the incision.
• The skin surrounding the areola is brought down and together to reshape the breast.
• All incisions are closed with strategically placed sutures to minimize scarring.

After your breast lift procedure, the shape of your breasts, the height of their projection, and their balance/symmetry will be greatly improved. Incision scars will fade over time. Your goal during the recovery period is to keep the incisions free from infections, which can worsen scarring.

Recovery time

Although each individual will have somewhat varied recovery times, there are general guidelines that can help you understand what to expect throughout your recovery.

Before your surgery, you should arrange to take 1-2 weeks off of work. You will need to arrange for someone to drive you home after the surgery and help you in the first couple of days following the surgery.

You will likely experience some pain and discomfort during the first couple of days after your surgery. Your doctor may provide you with medication to help you manage the pain, and you may also be prescribed antibiotics.

Swelling and bruising will peak around 3 days following the surgery, after which time they will gradually begin to subside. Minor swelling will persist for several months.

Exercise should be avoided for at least 4 weeks after surgery.  Post-surgery garments should be worn for approximately 6 weeks before returning to normal bras.

Scars will gradually fade over time, but it is important to avoid sun exposure, which can permanently darken scars.

It is imperative that you adhere to all instructions that your surgeon gives you in order to achieve the best outcome. If you have questions or concerns during your recovery, contact your surgeon.

Breast lift scars

Scarring is unavoidable in breast lift surgery, but can usually be well concealed depending on the variation of breast lift technique used by your surgeon. You may end up with a crescent shaped scar at the top of your areola, a scar around the circumference of the areola, or a vertical scar running from the edge of the areola to the breast crease. These fade and become very light over time.

When will you see results?

Preliminary results of your surgery will be visible immediately, but you will have noticeable amounts of swelling in the first several days after the operation. Swelling will gradually go down over the subsequent weeks, but it is important to understand that it may take 3-6 months before you can appreciate the final results of your surgery. As your incisions heal, the scars may be slightly red, but they will fade to fine white lines that should be inconspicuous within several months to a year or more.

How long will your results last?

To answer this question, you have to consider how breasts change over time. Weight gain adds a lot of excess tissue to the breasts; with the added weight, it’s possible that there will be sagging – whether or not there already has been a breast lift surgical procedure done. If you lose weight, the resulting skin without volume will also sag. Thus, to predict how long-lasting your results will be, you have to predict whether you will have additional weight gain – and weight loss in the future.

Pregnancy also makes a big impact on breast tissue. If you become pregnant after you have had a breast lift, the results of the breast lift procedure will be changed.

Breasts also change over time because of the effects of gravity. Thus, over time, your results will start to diminish due to aging.

There are steps you can take to increase the longevity of your breast lift, including:

• Wear a properly fitted, supportive bra
• Sleep on your back
• Don’t smoke
• Maintain a stable weight
• Eat a healthy diet
• Exercise regularly

Cost of breast lift surgery

Generally speaking, you can expect the total cost of breast lift surgery to be between $7,500 and $10,000. There are a number of factors that determine the cost of breast lift surgery, including:

• Surgeon’s fee
• Anesthesia fees
• Hospital or surgical facility costs
• Medical tests
• Post-surgery garments
• Prescriptions for medication
• The type and extent of your surgery
• Whether you have additional procedures done

When you get your quote, make sure that the cost includes all expenses, not just the surgeon’s fee.

If your doctor recommends breast reduction or breast augmentation, these are additional costs. Average cost of breast reduction is $6,500 to $12,000 while the average cost of surgery for breast augmentation is $5,000 to $10,000. In many cases, if you’re combining procedures there will be a discounted rate.

Health insurance does not generally cover the cost of a breast lift surgery. Many surgeons do offer monthly payment plans that can fit into your budget. Ask your surgeon about financing options during your consultation.

Safety information

All surgeries are associated with potential risks, and breast lift surgery is no exception. Some potential breast lift complications that may occur as a result of surgery include:

• Negative reaction to anesthesia during the surgery
• Infections
• Bleeding
• Nerve damage
• Medication allergies
• Blood clots
• Scarring
• Damage to anatomical structures in the area of the surgery
• Hematoma

The best way to avoid these complications is to find an experienced, board-certified surgeon to perform your breast lift. After the surgery, carefully follow all instructions your surgeon gives you.

FAQs

Q: Can I get a breast lift without implants if I’m happy with the size but want perkier breasts? A: Yes! There is no need to have additional procedures if you don’t want them.

Q: What kind of incisions or techniques leave the least amount of scarring in a breast lift? A: The periareolar incision is a circular incision that is made around the perimeter of the areola (the pigmented skin surrounding your nipple), and it is the smallest incision that can be used while still getting a complete breast lift. However, not all women are candidates for this incision. Larger breasts and substantial sagging may require a larger incision. If you are concerned about scarring, discuss your options with your surgeon.

Q: Is it possible to breastfeed after breast lift surgery? A: In most cases, yes, although you may produce less milk than you did before the surgery. However, if the nipple has been detached from the underlying tissue, you may not be able to breastfeed. This is very uncommon.

Q: How does a breast lift impact nipple sensation? A: In most cases, people who get a breast lift will not lose any nipple sensation. A small percentage (~10%) of patients may have temporary loss of sensation. In very rare cases, permanent loss of sensation may occur.

Q: Is it possible to fix uneven breasts without getting implants? A: In many cases, a breast lift alone can improve the symmetry of uneven breasts. In cases where breasts are very asymmetric, a breast lift combined with fat transfer can work wonders. To learn about your options, set up a consultation with a board-certified plastic surgeon.

Alternatives to breast lift surgery

There are alternatives to breast lifts, however it’s important to understand some of these treatments  some of which have clinical studies to support the effectiveness than others at improving the appearance of sagging breasts. Here are some additional options to consider:

1. An “Internal” Bra: This is an interesting procedure that involves surgically inserting a mesh ‘bra’ that lifts your breasts. The mesh bra provides a little extra structure, although over time the mesh is broken down and absorbed by your own tissues.
2. A Bra Lift with Laser (Laser Bra Lift): Laser bra lifts may be used in addition to a breast lift. In the laser bra surgery, a laser is used to create a bra-like effect that is supposed to help protect the surgical results of the breast lift. Laser energy stimulates the production of new collagen fibers, which may give you more support of any tissues.
3. Botox Breast Lift: With this procedure, Botox is injected into your pectoralis muscle, which causes a relaxation of the muscles in the chest and allows your back muscles to lift your breast. The lifting is not dramatic though, and it only lasts about three to four months. However, according to the American Society for Aesthetic Plastic Surgery, “Botox is not intended to be used to lift or rejuvenate the breast.”
4. A Vampire Breast Lift™: This is one of the newest alternative methods. It does not require surgery. Instead, a platelet-based injectable is created that is made out of your own blood. The injection is given into areas of the breast where lifting and firming are needed. It’s important for patients to understand there hasn’t been any studies on the effectiveness of this treatment and is therefore still considered experimental by many surgeons.
5. Thermage: Thermage is an FDA approved procedure that tightens the skin via the use of radio waves. The tightening firms the skin and lessens some of the sagging. It’s another nonsurgical procedure that may provide minimal results depending on the degree of sagging.
6. Breast Lift Fat Transfer: A fat transfer, or fat-grafting, uses liposuction to remove fat from another part of your body and transfers it into your breast. Fat transfers are particularly helpful when sagging breasts look ‘deflated’. Fat transfers can be done alone or in addition to a breast lift.
7. A Well-Fitted Bra: You may be amazed at how a well-fitted bra will help your breasts look better. In addition, a properly fitted bra can prevent further sagging by supporting connective tissue that would otherwise become weak and lose the ability to support the weight of your breasts.
8. Chest Exercises: Your breast is made of the pectoralis major and minor muscles. Thus, strengthening these muscles is a way to firm breast tissue. It may not help if there’s a lot of sagging, but the subtle improvement may be enough for you.
9. Breast Creams: In order to be effective, a breast cream has to stimulate collagen production on a large scale to make a big difference when your breasts are sagging remarkably. Many of these creams promise the moon but don’t offer much in the way of results. They are simply marketing gimmicks.

How to choose your surgeon

To get the best results from your breast lift, it’s recommended that you take the time to find an experienced plastic surgeon. Don’t be afraid to interview several surgeons before you choose one. The surgeon you choose should be board-certified and hold current membership of one or more of the following organizations:

• American Board of Plastic Surgery (ABPS)
• American Society for Aesthetic Plastic Surgery (ASAPS)
• American Society of Plastic Surgeons (ASPS)

Although board-certification and membership in any of these organizations does not guarantee a successful outcome, you can be confident that the surgeon has met stringent criteria and is highly trained and experienced. Many surgeons display the logos of societies that they hold membership in on their websites.

You may also consider contacting your state’s medical board to confirm that the surgeons you are interviewing are licensed to practice in your state. You can also find out whether any disciplinary actions have been taken against them.