Breast Lift Reshaping
When Should I Consider a Mastopexy, or “Breast Lift”?
- Stretching of the breast skin/tissue/ligaments due to pregnancy, weight loss, breast feeding, genetics, or aging
- Loose skin, or breast drooping or sagging, and loss of upper breast fullness
- Low nipple and areola position (nipple position below the breast crease or nipple may be pointing downward)
- Enlarged and/or stretched areola (the pigmented region around the nipples)
- Desire for a “perkier” breast shape
- Desire to wear a strapless dress without a bra
- An elevated, more round breast contour with increased firmness
- Increased fullness in the upper portion of the breast
- Re-establishes a more “perky” appearance by tightening the skin envelope and re-positioning the nipple on the breast mound
- Improved location of the nipple and areola on the breast mound and
- Decreased diameter of the areola
Dr. Kimberly Short, a board certified plastic surgeon, has been selected as a speaker for board certified plastic surgeons highlighting her technique on breast re-shaping and discussing her mastopexy approach with breast augmentation surgery. Dr. Kimberly Short is a premier breast surgeon and her most recent presentation was a discussion on “Staging Breast Augmentation and Mastopexy” surgery with an analysis on the advantages and disadvantages dependant on patient anatomy, skin envelope characteristics, past medial history including smoking, significant weight loss, etc. and desired improvements.
The purpose of the breast lift or mastopexy procedure is to re-shape the breast mound, raise the nipple areolar complex and address the sagging, stretched breast skin envelope. A breast lift or mastopexy procedure will maintain your current breast volume or if desired the breast volume may be increased with a breast implant or decreased with removal of breast tissue. There are also many types of breast lift or mastopexy approaches depending on your goals and your anatomy.
To achieve a more youthful breast appearance, the excess breast skin must be tightened with repositioning of the breast tissue to create a rounder, firmer contour and the nipple/areola area is lifted to a more central location. An evaluation in the amount of skin stretch and position of the nipple will indicate if a breast lift or mastopexy will be recommended to a patient. In some patients, a breast implant (breast augmentation) can improve the shape of the breast by filling out the skin envelope and raising the nipple without a breast lift or mastopexy technique. If the breast ligaments and skin have been stretched significantly with a nipple position located below the breast crease or with the nipple pointing downward, than a breast lift or mastopexy is recommended with or without a breast implant. Typically, there are four general types of breast lift or mastopexy techniques:
1. Periareolar Mastopexy or referred to as “Benelli”: Incision confined to the areola; obviously the most limited incision but many patients are not candidates for this approach depending on the degree of improvement desired with breast ptosis or sagging.
2. Lollipop or referred to as Dr. Short’s Standard Mastopexy (most common) or “Short Scar”: Incision encircles the areola and extends downward to the breast crease in the shape of a lollipop; this approach is the most common because most women need the vertical incision for skin tightening in the vertical component to achieve the desired perkiness, upper pole fullness, and nipple position improvement.
3. Wise Pattern Mastopexy (least common): Incision encircles the areola and extends downward to the breast crease, then extending from side to side in the breast crease; this approach may be recommended for patients whom have undergone massive weight loss and require this extended incision approach due to the severity of excess skin to the breast skin envelope.
4. Mini-Mastopexy: Incision placed in the inframammary breast and lengthened to remove excise skin in the lower pole of the breast skin envelope; lowering the nipple position and decreasing the distance from the nipple to the crease distance. This approach is recommended more commonly for previous augmented patients whom have had breast implants and developed stretching of the lower pole of the breasts, causing the nipples to be too high on the breast mound.
Regardless of the incision, the principals of the technique are similar. The mastopexy or breast lift incision is placed around the nipple-areolar complex (pigmented portion around the nipple) to decrease the size of the areola and to re-position the nipple location. The nipple is not removed and sensation is preserved. Dr. Short’s technique uses a permanent pursestring suture around the areola to maintain the diameter long term; this suture is the only permanent suture placed for a breast lift or mastopexy surgery. A vertical incision is also made to re-position the breast tissue, remove the excess skin and tighten the skin envelope. This standard mastopexy or breast lift incision is referred to as the “lollipop” incision. Typically, Dr. Short will not extend the incision into the breast crease.
If the ptosis or sagging of your breasts is less pronounced, a limited incision may be placed only around the nipple-areolar complex called a periareolar mastopexy. If the nipple is centrally located on the breast mound but sagging is limited to the lower breast area, then a mini-mastopexy or mini-breast lift may be recommended by making an incision in the inframammary breast crease.
There are many options for breast lifts depending on the amount of excess skin and degree of low nipple position. Dr. Short can use several limited techniques to decrease scarring and create a prettier, firmer breast shape for you. The breast lift or mastopexy surgery may be combined at the same as breast augmentation surgery or a staged approach is recommended for patients to improve the breasts scars. If a staged approach is recommended, than a breast lift or mastopexy surgery is performed first and after a minimum of 3 months, a breast implant can be placed to increase the breast volume, provide more upper pole fullness and create more firmness to the breasts. Dr. Short may be more encouraged for staging of the breast lift and breast augmentation procedures if the patient has a history of smoking or tobacco use or the patients anatomy indicates improved scarring or long term results with staging. Due to the incision placement and re-positioning of the breast tissue and nipple, patients are required to stop all smoking and use of tobacco products a minimum of 3-6 months prior to surgery to ensure an adequate blood flow and healing after surgery. Smoking has been shown to decrease blood flow to the incision by at least 30% and has been shown to cause complication related to healing, even in healthy patients where smoking is the only risk factor.
Planning the Surgery:
Time off Work:
7-10 days with lifting restrictions of less than 10 lbs for the first 2-3 weeks after surgery.
You will need a caregiver for the first 24-48 hours postoperative. If you do not have someone to care for you, a nurse can be provided for a minimal fee.
The Day of Surgery:
The procedure is performed on an outpatient basis under general anesthesia. Typically, the procedure takes approximately 2-4 hours to perform depending on the type of approach and if combined with a breast augmentation procedure. Patients are required to return the day after surgery for a post-operative appointment.
You will go home with only light dressings over the incision sites and a surgical bra will be worn for two weeks to provide adequate support. You may shower after 72 hours. Skin glue adhesive or steri-strips are applied to the incisions and will remain intact for 2 weeks. Scar treatment options are available at your two week appointment. Extensive taping to the breast incisions is recommended for the first 6-8 weeks to improve scarring. The scars will fade over time. The surgery does not eliminate the ability to breastfeed. Light activities can be resumed after 10-14 days and aerobic activity may be resumed at 6 weeks after surgery.
Note: It is important to address any concerns with Dr. Short at the time of your consultation. There is some risk, as with any surgical procedure. Minor complications that do not effect the final outcome occur occasionally. Major complications are unusual. Dr. Short can explain the procedure and potential complications to you in detail, and she can assist you in determining if a breast lift is right for you