Breast Lift or Mastopexy

A breast lift or mastopexy may be an option when breast augmentation cannot be performed due to excessive looseness of the skin. This is particularly common following pregnancy with breast-feeding and following weight loss. Implants alone can improve loose skin if the nipple is at or above the underlying breast fold. If the nipple sags or hangs below the breast fold, placing an implant usually will not adequately raise the nipple, creating an unfavorable outcome with the breast still hanging off the implant. In these cases the skin must be tightened and the breast reshaped to allow augmentation. There are three common forms of breast lift. In borderline cases, the nipple can be shifted upwards just enough to allow augmentation using a “crescent lift”, which just removes a little wedge of skin and allows repositioning of the nipple and areola only. Often this is performed on one side only, when there is an asymmetry between the two breasts. An intermediate form of lift is called a periareolar or “donut” lift. In this case the skin is more widely tightened up around the entire nipple areola, limiting the mastopexy scar to the border of the areola. Newer techniques allow internal tightening of the breast tissue too, which has expanded the application of this lift and allowed us to limit scarring with more mastopexy procedures.

In the case of an extremely droopy breast with most of the gland hanging below the breast fold, a full breast lift is required. The nipple is repositioned to its new ideal location and the skin is tightened up around the entire breast mound, eliminating all or most of the skin which was hanging below the breast fold. In this case it is necessary to place an incision on the lower pole of the breast which resembles an upside down “T”. These incisions are identical to a breast reduction, however, with a reduction, a significant amount of breast tissue is removed in addition  to the skin. These procedures almost never require removal of the nipple, just repositioning, and in most cases sensation and function remain intact.

With each of the mastopexy procedures breast implants can be placed simultaneously. Crescent and periareolar lifts are almost always performed with breast implants. A full breast lift however is often performed without an implant, especially when there is already a substantial amount of breast tissue. In addition, with a full mastopexy , placing a very large implant is impractical and may be unsafe since the breast lift is trying to tighten the skin and the implant is trying to expand it. The implant more commonly end up slightly out of position. More importantly, there is  significant disruption of the normal blood flow within the breast  and healing problems are far more common when implants are placed at the time of a full mastopexy. At the time of your examination we’ll explain this more thoroughly. We'll determine which approach is best for you and help you make decisions regarding breast augmentation simultaneously or as a future, separate procedure. Future augmentation following a full breast lift can allow both excellent tightening and reshaping as well as a very large augmentation if that is your goal. Recovery for any of these procedures is similar to that for breast augmentation.

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Disclaimer for breast lift: This breast augmentation website is intended to provide general information regarding breast enhancement and to help you find a Dallas cosmetic surgeon.