Breast Lift (Mastopexy) Basics

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What is a breast lift?

A breast lift (mastopexy) is powerful procedure that can lift the nipple, reduce excess skin, and reshape the breasts to sit higher on the chest in a more youthful position. A breast lift is appropriate for patients with breasts that are adequately sized but saggy; but can also be done in combination with an implant to add volume (breast lift – augmentation), to adjust for asymmetry, or to improve unusually shaped breasts (tuberous breasts).

The gold-standard method of assessing the need for a breast lift is the “pencil test.” Standing in front of a mirror, lift the breast and lay a pencil in the fold under the breast and allow the breast to settle over the pencil. Look at the position of the nipple in relation to the pencil.

Pencil Test For Determining Degree of Breast Ptosis. Place pencil in breast fold (under the breast). If nipple is at or below the pencil you will likely need a breast lift to avoid post-operative deformity after augmentation.
Pencil Test For Breast Ptosis

Did you “Pass” the Pencil Test? Read more on Breast Augmentation.

What surgery is right for me?

A detailed examination will help delineate the best surgical treatment. The goal of a breast breast lift is to create an aesthetic breast with the size, shape, and projection that is desired by the patient. The decision about the type of surgery and, if needed, the size, shape, and position of the implants is based on the patient’s anatomy, the type and size of the implant, and patient’s preferences.

The lower the nipples and breast are below the pencil and the more excess skin you have, the greater the chance you will need a breast lift and the more of a breast lift you will need. If your nipple and a majority of your breast are at or above the pencil (Normal), you will likely get a great result from a breast augmentation alone. Larger implants can shift this equation slightly for patients that have borderline ptosis (Grade 1).

Breast Lift Incisions: Peri-Areolar, Lollipop, and Inverted "T"
Breast Lift Incisions: Peri-Areolar, Lollipop, and Inverted “T”

The trade off with a breast lift, is a scar on the breast around the nipple with a possible extension down towards the breast crease creating a lollipop or possibly an inverted “T” pattern. The choice of incision is based on multiple factors including patient anatomy, surgeon preference, and patient preference.

During your consultation, measurements of the breasts are used as a starting point to recommend a surgery and in-office sizing and digital three-dimensional computer simulations are used to help guide your implant choices.

What Is The Recovery Like After A Breast Lift?

After surgery, the breasts swell from the trauma of surgery and the tissues become edematous. As the swelling subsides and the tissues begin to stretch from the weight of implants, the breasts begin to settle. Over the next few months, the breasts settle as the soft tissues relax. The shape changes from high and tight to lower and fuller as the breasts round out and more of the implant is in position to provide lower pole projection.

This “drop and fluff” often occurs over the first few months after surgery as the edema finally escapes and the soft tissues relax. This process is often asymmetric as the breasts relax and settle at their own rates. It will take 3 to 6 months to see a final result – although for some patients this process occurs faster.

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