As part of the natural aging process, women lose skin elasticity in their breasts, gravity takes its toll, and breasts begin to sag.  Other factors including pregnancy, breast-feeding, and excessive weight loss can produce similar results.  When shape and firmness of the breasts change, some women become unhappy with their appearance and wish to return to their more youthful look.  In these cases a breast lift or mastopexy can reduce or eliminate sagging, and, for women seeking enhancement in size, can be performed in conjunction with implants to increase the breasts' volume.

How It's Done

In most instances, mastopexy is performed under general anesthesia as an outpatient procedure, and lasts between one and three and a half hours.  For some women, usually those that require less skin removal and quicker, less invasive surgery, a breast lift can be performed under local anesthesia, while others, typically those with larger breasts that require more extensive surgery, require inpatient surgery with a hospital stay of one or two days.  There are three basic techniques used for breast lift surgery: concentric mastopexy, vertical mastopexy, and anchor-shaped mastopexy.

Concentric Mastopexy

During concentric mastopexy, circular incisions are made around the areola.  The skin between the two incisions, shaped something like a doughnut, is removed, the nipple and areola is replaced, usually moved upward, and the surrounding skin is stitched to the skin around the areola.  Because there is a relatively small amount of skin removal, this technique will only work for women with smaller breasts and minimal sagging.

Vertical Mastopexy

Using a similar technique to that of concentric mastopexy, the surgeon will extend the incision vertically bellow the areola to the breast crease by the chest.  This approach allows an additional strip of skin to be removed, giving the surgeon the option of greater correction.

Anchor-Shaped Mastopexy

This is the most invasive and most common type of breast lift surgery.  An incision is made above the nipple in the shape of an anchor, with a circle at the top.  This incision forms the shape of the new breast with the nipple placed in the circle at the top of the anchor, and the elliptical line at the bottom forming the lower contour.

After the incision, the skin bellow is removed, the breast tissue and nipple lifted to a higher position, and the incision site is stitched closed.

Technology

Though advancements in technology have allowed surgeons to perform procedures with less invasive techniques, these options in mastopexy are limited depending on the patients need and desire.  Your surgeon can help determine your best option after observing your particular case, desired results, and medical history.

Recovery / Post Op Expectations

After surgery patients are wrapped with gauze and elastic bandages or a surgical bra.  Bruising, swelling, pain, and discomfort will be experienced for the first few days, but medication will be prescribed to help lessen the effects.  Loss of sensation in the nipple and breast tissue is common, but usually returns as nerves begin to regenerate.  Heavy lifting, excessive physical exertion, raising or lifting hands above your head, and sex should be avoided for at least a week or more, and patients should expect to be absent from work for approximately the same time.

Complications

As with any major surgery, complications are a very real possibility.  Adverse reaction to anesthesia, infection, and blood clots are possible with any surgery.  In addition, mastopexy carries with it some surgical risks that patients should be aware of prior to surgery, including:

• Asymmetry
• Permanent numbness of nipple or tissue
• Excessive scaring
• Nerve damage
• Irregularity in nipple position
• Discoloration of skin and nipple

When implant are being used in conjunction with a lift, additional risks including implant leakage and interference with mammograms are possible.

Am I A Candidate?

Candidates for surgery have drooping or sagging breasts, and wish to have this corrected.  Though surgery does not usually interfere with breast-feeding, it is best to not have surgery if you plan on becoming pregnant in the future as this could negate the results of surgery.

Costs

The national average surgeon fee for 2003 was $3,857 according to the American Society of Plastic Surgeons (ASPS), but can range from $4,500 and up when additional costs including anesthesia are considered.