Breast lift, also known as mastopexy, is the surgical procedure which tightens the “skin brassiere” in order to provide a more youthful appearance to the breast. Most often after childbirth there is a deflation effect, particularly after breast feeding. I have found that the solution to this problem can involve anything from a small “mini-lift” with placement of an implant to fill the loose skin, to a standard mastopexy – with or without an implant at a later date.
There is also now a new option which I’m really excited about. It involves a standard mastopexy with a new technique I am using called suture shaping. The best solution for each patient depends upon your anatomy and the end result you desire. We can work through these various options at your consultation.
The standard mastopexy is usually performed when the patient is happy with her volume (cup size), but is bothered by the saggy appearance of her breast. It involves excision (removal) of an anchor-shaped piece of skin in what is known as a “keyhole pattern”. The resultant scars are in the crease or breast fold –a vertical scar from the mid crease to the bottom of the areola – and a circumferential scar around the areola. (The areola is the pigmented circle of skin that surrounds the nipple.) The appearance of your scar is ultimately determined by your genetics, but we find that these scars generally do really well over time – fading nicely and not being too noticeable.
A common problem in doing a standard mastopexy is that it initially pushes up the breast tissue, creating upper-pole or top-of-the-breast fullness, but it typically doesn’t last. With the inevitable settling, the first place the volume leaves is the top of the breast. In the past, we told patients that the only way to get long-term upper-pole fullness was to place a small implant but now, we have an exciting new option known as “suture shaping”.
The skin portion of the surgery is exactly the same as with a standard mastopexy, but we place a series of sutures in the breast gland tissue before closing the incision. The process is somewhat like pushing in on a bean bag chair (the gland) and placing sutures to hold this “infolding”. By doing a series of these infolds and tucks, we are able to change the shape of the gland from a hamburger shape to a more conical projecting shape. The effect is to make the patient’s own tissue look like an implant!
I even place some sutures to suspend this shaped mound of breast tissue to the pectoralis muscle to keep it in the position we want. We have been doing this procedure for over a year, and the early results look really positive. We are maintaining much more upper pole fullness than with the standard mastopexy, and in most cases won’t require an implant to achieve that result.
The approach with the least amount of incisions is the mini-lift, which may involve a crescent-shaped skin excision just above the areola. This usually goes from the 3 o’clock to the 9 o’clock position and leaves a scar right at the edge of the areola. Sometimes we will combine an inframammary mastopexy with the nipple lift. This involves excision of a wedge shaped piece of skin from the bottom of the breast. The resultant scar is located right in the breast fold or crease, and again, is not too noticeable long term in most cases. Most often the mini-lift procedures, nipple lift and inframmary lift are combined with placement of an implant to fill up the skin envelope. Photos of these procedures demonstrate the benefit of this combination of skin adjustment with an implant.
Breast lift or mastopexy can produce a wonderful improvement if you are suffering from a bra size of 36 “long”. It is critical, however, that you select a surgeon who has significant experience in the various breast lift techniques. Be absolutely sure to ask how many of these procedures the surgeon does or has done, and insist on seeing a number of before and after photos. If you would like a more perky, youthful appearance to your breasts, I’d be happy to meet with you and go over the options that are available. I look forward to the opportunity.
Below is an example of a breast lift before and after photo. If you would like to see more before and after photos, click on "Photo Gallery" on the left.
Written by: Dr. Bruce W. Van Natta