What is a Breast Lift?
Mastopexy, more commonly referred to as a breast lift, is a procedure designed to raise the breasts to a more youthful location on the chest wall while elevating the nipple-areolar complexes and minimizing breast sag. This is accomplished by tightening the breast skin envelope, as well as removing excess skin. A breast lift is often utilized when the nipples are positioned approximately at—or slightly below—the breast crease, signaling a downward migration of breast tissue caused by pregnancy, breastfeeding, weight fluctuation, or the forces of gravity and the aging process. In general, a breast lift can improve the shape, projection, symmetry, and positioning of the breasts for natural-looking results and an improved breast contour.
Mild breast sag may be corrected through the insertion of breast implants alone in a dual-plane breast augmentation procedure, which can be ideal for patients who wish to add breast volume and experience light breast drooping. However, more extensive breast tissue laxity is typically addressed more effectively with breast lift surgery. Mastopexy can also be combined with a breast augmentation in a procedure called a breast lift with implants for women with moderate to severe breast sag who desire volume enhancement and breast rejuvenation simultaneously.
Who is a Candidate for Breast Lift Surgery?
Ideal candidates for a breast lift are women with moderate-sized breasts who are finished having children. Each patient has different anatomical indicators and there may be a number of breast enhancement options to address your aesthetic concerns. Mastopexy is a highly personalized procedure tailored to your unique needs; therefore, speaking to our Minneapolis plastic surgeons, Joe Gryskiewicz, MD (“Dr. Joe”) and Karan Chopra, MD, extensively about your cosmetic goals is pivotal. Dr. Joe or Dr. Chopra will help you decide which procedure is the best treatment to help you realize your aesthetic ideal.
Extremely large and heavy breasts (D-cups or larger) tend to sag soon after a mastopexy, so women with a larger breast size may not be good candidates for this surgery. The problem is that the skin envelope simply can’t withstand the effects of gravity; although in some cases, internal sutures, absorbable mesh, a muscle sling, or other techniques may be used to suspend the breast tissue. Pregnancy may also undo the positive effects of the surgery.
Dr. Joe or Dr. Chopra will do a breast examination and take careful measurements of your nipples in relation to other parts of your breasts and torso. Perhaps you’ll only need a lift on one side. The size and shape you expect may not match what our surgeons have in mind, so bring pictures to your consultation to portray the outcome you envision. Dr. Joe and Dr. Chopra will also give you a general idea of where your areolas and nipples will be positioned after surgery.
Considerations Prior to Breast Lift Surgery
When it comes to breast lifts, the most important element with regard to patient satisfaction is realistic expectations. Remember that results aren’t permanent. Gravity, aging, and weight ﬂuctuation can take their toll on your breasts again. Scarring will be considerable, even in “minimal incision” breast surgery. Be prepared for these outcomes before going ahead with a mastopexy.
Here are some other factors to consider when deciding whether to have a mastopexy:
- If your breasts differ markedly, do you want an enlargement or a reduction in size?
- How much scarring can you tolerate as a trade-off for a breast lift? Determine with your surgeon which lift procedure will give you the most improvement with the least amount of scarring.
- Do you want a smaller areola? If so, how much smaller?
- Are you planning to have children or breastfeed in the future? If so, your results may not last and your surgery should be deferred until your family is complete.
Listen carefully to your plastic surgeon’s recommendations. Take notes if necessary. Ultimately, you’re the one who has to live with the results. Your surgical plan will be drawn on your own photos and stored in your web account on TouchMD.
A breast lift is largely a three-dimensional operation, meaning any changes will affect the shape, size, and projection of the breasts together. Combining the surgery with breast augmentation, which is also highly three-dimensional, can create some differences in symmetry between one side of the chest and the other. In a combination breast lift with implants procedure, another potential complication may involve the implant appearing too high on the chest wall due to the muscle attachments or relaxation of the breast skin envelope. Dr. Joe or Dr. Chopra will talk to you about all of the potential risks of the breast lift procedure, however rare, during a consultation so you can make a well-informed decision about your cosmetic enhancement. To see the results achieved by previous procedures, please feel free to peruse our breast lift before-and-after photos as well as our breast lift with implants patient gallery.
How is Breast Lift Surgery Performed?
This is a same-day procedure usually done under general anesthesia, but occasionally under intravenous sedation if limited incisions are used. The procedure takes about one and a half to two and a half hours. Depending on the nipple level and amount of excess skin, incisions can range from a small crescent above the areola to the classic incision pattern that looks like an anchor. Dr. Joe has created a procedure that uses a wavy incision around the areola, which can better camouﬂage the scar (published in Plastic and Reconstructive Surgery, 2002, p. 1778, “‘Zigzag’ Wavy-line Periareolar Incision”). Any of the mastopexy procedures may be done in combination with breast implant placement.
The most limited procedure involves removing a crescent or half-moon pattern of skin horizontally along the top of the areola. This leaves a curved scar along the top half of the areola. Crescent mastopexy can be used when the nipple needs to be raised about half an inch. It works well in combination with breast augmentation because the implant’s volume also supports the nipple in an upward direction. Some surgeons prefer to place the implant on top of the muscle in a mastopexy procedure.
Note: This incision may “bottom out” a larger breast as the tightened upper breast pushes the still-relaxed lower breast down and out.
Doughnut or concentric mastopexy involves a circular incision around the nipple. A doughnut, or ring of skin anywhere from one-half to two inches is removed. Upon closure, the breast skin is tightened around the open doughnut as the nipple is elevated. This procedure is appropriate in a limited number of patients with smaller breasts and minimal sagging. It may ﬂatten the breast slightly and cause radiating folds of skin, but the technique can avoid more extensive scars. Doughnut mastopexy may be extended with additional skin removal from below the breast, which helps support the breast upward.
This procedure has various forms. The most common incision follows the natural contour of the breast, with skin removed around the nipple, down the breast front, and horizontally along the crease. Internal tacking is often placed to support breast tissue higher on the rib cage. The nipple and areola are moved higher. Surrounding skin is pulled tight to shape and support the breast. This leaves an anchor-shaped incision. If an implant is placed, it will further support the breast.
I am very pleased with the results produced by Dr. G’s surgical skill. Dr. G and his staff are pleasant and extremely helpful. None of the questions I asked were too trivial for their attention. Dr. G provided excellent information giving me realistic expectations for what was possible for my situation during the initial consultation. In fact, my expectations were exceeded.
What is Recovery From a Breast Lift Like?
Your breasts will be bruised and swollen after surgery. Swelling will be minimal to moderate and last several weeks. Avoid salty foods to diminish excess swelling. Pain is moderate. Dr. Joe or Dr. Chopra will order pain pills and possibly an antibiotic. Most stitches are buried and can be dissolvable, so removal of only a few outside sutures should be necessary. Some surgeons use permanent sutures, which must be removed. Drains are rarely necessary. (A drain is a small plastic tube connected to a light-bulb shaped reservoir. The compressible reservoir creates gentle suction to remove excess ﬂuid from the surgical area. The recovery room nurse will teach you how to care for the drain prior to your discharge from the surgery center.)
Immediately after surgery, you may wear an elastic wrap or surgical support bra with gauze bandages. When you switch to a good support bra, wear it around the clock for three to four weeks. Avoid vigorous exercise or direct contact and avoid sleeping on your stomach for the same amount of time. Sexual activity that causes pain in the surgical area should be avoided for the same amount of time.
Mild depression following surgery is normal, and typically results from the anesthesia. The best thing to do is ride it out—it should pass quickly. Massive swelling on one side compared to the other, fever, redness, or unusual drainage are all cause for concern. Call immediately if you experience any of these reactions. It is important to avoid lifting anything over your head for at least four weeks after a breast lift. The same holds true for engaging in strenuous exercise or sports.
Will I Have Scars After Breast Lift Surgery?
All breast surgery procedures will leave some amount of scarring, but the visibility of your scars will depend on which breast lift procedure is best for your anatomical needs and cosmetic goals. Our plastic surgeons will show you the anticipated shape and size of your scars during your consultation so you can have an idea of what to expect and make a decision about your care accordingly. The crescent-shaped incision typically produces the least amount of scarring and the scar is virtually imperceptible once fully healed. The most common procedure performed is a classic mastopexy, which typically leaves a vertical scar from the base of the nipple to the breast crease, as well as a horizontal scar along the breast fold. In some cases, a variation of the classic breast lift known as minimal incision or short scar surgery (“lollipop incision”) can be performed with less scarring than a standard mastopexy. This technique eliminates the incision across the breast crease. Generally speaking, a smaller breast size often produces shorter incisions and resulting scars.
There are a number of ways to lighten your breast lift scars and minimize their visibility. Always be sure to follow your plastic surgeon’s post-operative instructions on caring for your incisions. This will allow optimal healing and increase the likelihood of your scars fading somewhat over time. Other tips include applying sun protection and high-quality skin care products over your scars to decrease their prominence as the years go by.
How Much Does a Breast Lift Cost?
The cost of a breast lift will be unique to each patient, the ultimate price contingent on which surgical technique was used during your procedure and the extent of your aesthetic concerns. If breast implants were placed in conjunction with your mastopexy, the type of implants utilized will also affect the cost of treatment. The price of breast lift surgery can range from $5,000 to over $12,000 dollars, with the exact figure depending on whether you place implants, as well as the other details of your custom surgical plan.
Once you visit Dr. Joe or Dr. Chopra in a consultation and the complexity of your procedure is assessed, our office will be able to provide you with an exact quote of your expenses. If you would like to make the cost of surgery more affordable, we work with plastic surgery financing companies like CareCredit® and Alphaeon™ Credit to allow patients the option of paying for treatment over time. These healthcare lending companies offer an array of financing plans with low monthly installments, as well as low- to no-interest rates. Once approved, qualified applicants can choose the most ideal payment plan for their budgetary concerns. If you have any questions about the cost of a breast lift, please call our office to speak with a friendly member of our team.
What are the Risks and Limitations of a Breast Lift?
There is a chance of numbness in the nipple or scattered areas of the breast skin. Bleeding can occur, even to the degree that a secondary drainage procedure can become necessary. As with any surgery, infection is possible. Incisions also could separate in high-tension areas. This usually requires cleansing and antibiotic ointment for several weeks as these areas heal.
Mastopexy leaves noticeable scars, which can be covered by your bra or bathing suit. If you smoke or don’t follow recovery instructions completely, you’re at risk for tissue death and scars that can widen or become infected. The procedure also can leave unevenly-positioned nipples and other breast asymmetries.
The major issue with a breast lift is that gravity is a constant, especially with women who have larger, heavier breasts. With newer techniques of suturing the internal breast tissue to the chest wall, longer-lasting results can be achieved.
Can I Breastfeed After a Breast Lift?
In rare cases, mastopexy could affect your ability to breastfeed. The best way to help ensure your breast lift does not affect breastfeeding function is to always communicate your desires to your plastic surgeon. It may not always be possible, but Dr. Joe and Dr. Chopra can do their best to tailor the procedure to avoid disturbing the nerves and glands of the milk ducts. They will go over potential complications with you during your consultation so you can make a well-informed decision about your needs and goals. That said, our plastic surgeons generally recommend waiting until after all plans for pregnancy and nursing are complete before undergoing a breast lift, if possible. Subsequent pregnancies may stretch your breasts to their pre-procedure sagging state, so many surgeons avoid performing a mastopexy until patients no longer anticipate having another child.
Is a Breast Lift Without Surgery Possible?
There is unfortunately no non-surgical treatment that can effectively lift and rejuvenate the breasts. Since reducing sag requires the removal of excess skin, exercises that claim to naturally lift the breasts cannot replicate the results achieved with surgery. Working out the pectorals can certainly strengthen the chest muscles, but this will not resolve breast droop or achieve better breast contours. Many patients look to mastopexy because the procedure can not only restore the breasts to a more central positioning, but it also allows Dr. Joe and Dr. Chopra to address asymmetry issues and shape the breasts for a more aesthetic result. This all contributes to a more youthful, rejuvenated breast appearance.
If you would like to learn more about a breast lift procedure in Minneapolis or St. Paul, please contact our office to schedule a consultation.