Breast Lift (Mastopexy) Surgery
-Win Pound, M.D.
There are two goals to breast lift (mastopexy) surgery: to elevate
the nipple/areola to the “ideal” location and to tighten up the
skin “sling” below the breast, creating a better shape to the
breast. The trade-off for such surgery is scars. For the patient,
the choice comes down to whether you would rather have sagging
breasts or a perkier shape to the breast but with some scars.
Breast lift surgery is generally performed on an outpatient basis
under general anesthesia. The surgery takes from two to four hours
to perform. In my practice, patients may resume light activity when
they feel up to it, more strenuous activity after three weeks.
While there are several variations on breast lift procedures, they
can be reduced to three basic types based on the resulting scars.
- Peri-areolar (aka, “donut” or Benelli) mastopexy: This is an extremely limited type of breast lift, useful only for elevating the nipple/areola by a couple of centimeters. It does nothing to fill out excess, sagging skin and is therefore most useful when performed in conjunction with a breast augmentation. The good news is that it leaves the least amount of scarring, only a scar around the outer periphery of the areola. Patient selectivity is important with this approach. If done well, the scar should heal very nicely. If an attempt is made to elevate the areola too high, puckering and pleating of the scar may result.
- Vertical-scar (aka, “lollipop” or short-scar) mastopexy: This approach is useful in patients with slight to moderate sagging of the breast. The “lollipop” description accurately describes the scar which goes around the areola as well as up and down between the areola and the fold under the breast. The additional up and down scar allows tightening of the skin below the breast and also eliminates any pleating of the scar around the areola. This procedure can be performed with or without the addition of an implant for added volume to the breast.
- Standard (aka, “anchor”) mastopexy: This is the long-standing, traditional approach to breast lift surgery. It is best used for patients who have a significant amount of sagging. The nipple/areola can be effectively elevated, excess skin is removed, and the breast tissue can be better positioned with this approach. The trade-off is that this approach leaves the most scarring. It can also be done with or without the addition of breast implants for more volume.
While the risk of noticeable scars on the breasts may cause some patients to hesitate, scars tend to flatten and fade over time. There are also several treatment options which may minimize scarring. Overall, patients tend to be very happy with the results of breast lift surgery.