What is a mastopexy?

Breast lift operation involves making a decision to trade an improved breast shape and contour for some (well-placed and concealed) surgical scars on the breast. For the patient who is displeased that her nipples are downpointing, it may be a relatively easy decision. The surgical incisions are strategically placed to be as minimally noticeable as is possible. One component is around the areola, which is usually well concealed by the color difference between breast skin and areolar skin. The second component extends vertically from the '6 o'clock' position of the areola to the fold below the breast, and as the majority of this scar faces downward, it is usually quite acceptable.

The breast lift procedure I perform not only removes breast skin but also moves some lower pole breast tissue to a higher position, increasing the projection of the nipple/areola area.

Breast lift surgery works well for patients with enough existing breast tissue to build a projecting 'breast mound'. However, in most patients, it is difficult to create sustainable fullness in the upper poles of the breasts by means of a mastopexy alone. This is particularly true in patients who have experienced significant deflation following pregnancy and lactation.

For patients who indicate that they wish to achieve a fair amount of fullness in the cleavage area as a result of their breast lift surgery, I recommend that they undergo augmentation mastopexy. This surgery combines a breast lift with the placement of a breast implant usually of modest size, which produces the most youthful breast profile possible

Mastopexy refers to a procedure commonly known as a breast lift.  In this plastic surgery procedure, a patient with droopy breasts and excessive skin, undergoes a procedure wherein the nipple and areola are repositioned and the skin envelope is tightened. 

The procedure is commonly performed under general anesthesia and requires the expertise of a plastic surgeon to assess and individualize the incision pattern. 

In my practice, I commonly perform a Lejour, or short scar, type breast lift that minimizes surgical scars.  The inverted T-scar is another alternative with larger scars and is less commonly used.

Thanks for the question -

Mastopexy (breast - lift) involves reshaping the skin and usually the inner breast tissue as well to create a breast that is not as saggy as it once was.  This remodeling of the skin and tissue comes at a cost - scars.

Since you asked about mastopexies let's talk about them a bit.

The first mastopexies were done as early as the late 1800s and principally used "suspension" techniques placing sutures to try to lift the breasts (think thread lifts). 
More modern thinking recognizes the need to change the skin envelope around the breast tissue to get good correction of sagging breasts.

How common is a mastopexy?
In the US in 2004 there were reported over 98,000 mastopexy procedures performed.

Why do breasts sag?
Gravity is the master of us all.  Women with large breasts have a natural tendency to sag more over time.  The structural elements that help keep the breast in a more youthful position include things called "Cooper's ligaments" and of course the skin.  In addition weight gain, weight loss and post-pregnancy changes can cause breast ptosis (sagging).

Plastic Surgeons rank breast ptosis (sagging) in the following manner:

Grade 1: Mild ptosis - Nipple just below inframammary fold (your inferior breast crease) but still above lower portion of breast
 

Grade 2: Moderate ptosis - Nipple further below inframammary fold but still with some lower pole breast tissue below nipple
 

Grade 3: Severe ptosis - Nipple well below inframammary fold and no breast tissue below nipple; "Snoopy nose" appearance
 

Pseudoptosis - Inferior pole ptosis with nipple at or above inframammary fold; usually observed in postpartum breast atrophy
 

Treatment options:
For patients with mild breast sagging (grade I) sometimes increasing breast volume can correction ptosis.  Obviously ways to increase breast volume include breast augmentation or autologous fat transfers (I'd be happy to discuss these techniques in more detail - just contact me).

Some surgeons will combine a "peri-areolar mastopexy" with breast augmentation to try to get a lift in patients with a bit more sag.  This technique invoves excising a donut of skin around the areola (the darker area around the nipple) and suturing the area closed.
- it is important to understand the limitations of this technique both in terms of what it can achieve in terms of lift and the longevity of the lift.

More typically
Patients require more extensive remodelling of the skin envelope.  Techniques include "Wise Pattern" skin excisions which are the typical "anchor" scar, and a more vertical "lollipop" scar.  Some surgeons employ additional suture techniques to suspend the breast mound however I have found that typically suture techniques do not improve the appearance or longevity of the lift and that the scar tissue that forms naturally is adequate to gettin a lasting result.

Recovery is typically quick with the final breast shape settling in in about 2-3 months.

I hope this helps!