About Mastopexy (Breast Lift) by Los Angeles Board Certified Plastic Surgeon

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A breast lift, or mastopexy, is the lifting and shaping of sagging or uneven breasts. Mastopexy is very effective in improving the shape and appearance of breasts which have been affected by factors such as pregnancy, nursing, or placement of large breast implants for a prolonged period of time. Dr. Granzow is a Board Certified Plastic Surgeon in Los Angeles who performs mastopexy and other surgical procedures.

The best candidates for a breast lift

The best candidates for a breast lift are women who have completed pregnancy and nursing and have no plans for future children. This will allow the breasts to be lifted and shaped in one procedure. You can again become pregnant and nurse after having a breast lift. However, this may result in a restretching and sagging of the breast tissue. Also, nursing after any type of breast surgery such as a breast lift or reduction cannot be guaranteed.

Breast lifts are also very effective for women who have always had sagging breasts or stretched skin, even as a teenager. The chances for an overall improvement and excellent result are quite high. Dr. Granzow will go over the specifics of what you can and cannot reasonably expect during your consultation.

Women that are excessively overweight or have significant fluctuations in their weight should lose weight before a mastopexy. Breasts that are larger and heavier can be more difficult to improve than smaller breasts.

The results are long lasting, although women with heavier breasts may see some repeat sagging and stretching of their skin with time. However, this sagging and stretching, if it does occur, tends to be significantly less over time in a breast that has been lifted than a breast that has never had surgery.

What is the difference between mastopexy (breast lift) and reduction mammoplasty (breast reduction)?

While a breast reduction procedure seeks to reduce the size and weight of an overly large breast, a mastopexy (breast lift) seeks to improve the shape and appearance of the breast usually, without changing the actual volume of the breast in a significant way. A small amount of breast tissue and skin may need to be removed to shape certain breasts, but for the most part, the overall volume will stay the same.

Mastopexy plus Breast Implants

Placement of a breast implant may improve the volume and appearance of breasts that also required a breast lift. A breast lift performed with implants is a more complicated procedure than a breast lift alone. This is because the breast implant seeks to increase and expand the volume and stretch of the breast tissue and skin, while the breast lift seeks to shape and tighten the overlying skin. Surgery must be carefully planned and executed when such opposing forces are present to ensure the maximum chance of a safe result. Dr. Granzow will go over your individual situation carefully in each case.

The Surgery

The procedure usually takes between one-and-a-half and five hours, depending upon the size of the breast and the complexity of the procedure to be performed. This will vary significantly from person to person.

An incision is made around the nipple and areola. This extends down to the inframammary fold, which is the area where the lower portion of the breast joins the chest wall. This allows the excess breast tissue to be brought together and hidden in a vertical scar. Occasionally, a scar along this inframammary fold may be required as well. This may result in an incision which looks like an upside-down T underneath a small scar around the nipple and areolar complex.

As needed, the breast tissue underneath is sculpted by the surgeon. Small amounts of skin, fat or breast tissue may be removed to improve the overall shape and appearance. For example, volume may be reduced on the outside or armpit area and moved centrally and upward to provide for better shape and cleavage.

Occasionally, patients with less saggy breasts may have procedures performed with much smaller incisions. These incisions may be as little as a simple semicircle or circle around the nipple area. Dr. Granzow will go over the details of your situation during your consultation.

If an implant is required during the procedure, it will be placed at the time of the operation. Dr. Granzow usually uses a temporary, saline-filled adjustable implant while sculpting the overall appearance of the breast during surgery. This temporary sizer is then replaced at the end of the surgery with a permanent implant which is filled with either silicone or saline as required.

Risks of Mastopexy

Risks of mastopexy are low but they are common to all surgeons and hospitals. They include the standard risks of bleeding, infection, pain, and damaged nerves and vessels. Breast asymmetry may occur and loss of sensation or tissue may occur in the nipple or the breast area itself. Scars will be long and permanent and may even be wide and unsightly, although in most cases they heal well and fade significantly over time. Other risks include hematoma (blood clot), fluid collection or seroma and risks of anesthesia including the very low risk of blood clots in the lungs or legs.

After the Surgery

Breast lift surgery is usually not very painful. An elastic bandage or Ace wrap is usually placed at the time of surgery and this is removed the day after surgery. Drains are typically not required, although if they are needed then they are usually removed 1-2 days after surgery. The bandage is then replaced with a soft support bra.

The sutures are almost always self-dissolving and these will not need to be removed. Typically you can begin to return to normal activity several days after surgery and return to a desk job within a few days or one week after surgery. More strenuous physical activity is resumed gradually with moderate workouts allowed 2-4 weeks after surgery and full activity 6 weeks after surgery.

The Final Appearance

Scars will be present but these tend to fade significantly with time. Initially there will be some swelling but most of this will settle over the first few weeks after surgery. The subtleties of the overall appearance may take several months or more to finally take shape.

Since the effects of gravity are constant, breasts may sag again with time. However, a breast that has been lifted with surgery will tend to sag less over time than a breast that has never had surgery before.