BREAST LIFT (MASTOPEXY)

Breast lift surgery is often performed for patients who have undergone pregnancy, breast-feeding, or loss of skin elasticity that can affect the shape and firmness of the breasts. Women who feel that their breasts are “sagging” may be candidates for a breast lift to raise and firm them, resulting in a more youthful breast contour. Some patients may have lost a significant amount of breast volume over time as well, and in such cases, implants can be inserted in conjunction with a breast lift.
 

Good candidates for this procedure:

  • Patients who notice sagging of the breasts after pregnancy

  • Patients who notice sagging of the breasts due to time and gravity
  • Patients with breasts that are pendulous but adequate in size

  • Patients with nipples and areolas that point downward, especially if they are positioned below the breast crease

  • Patients with breasts that are large and heavy can be lifted, but the results may not be as long-lasting as a breast lift performed on smaller breasts; the weight of larger breasts works against surgical changes

  • Patients who are finished with childbearing and breast-feeding (If you plan to have children, you may want to postpone cosmetic breast surgery. Pregnancy may stretch the breasts and reduce their volume, compromising surgery benefits.)
     

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What to expect: Consultation

All cosmetic consultations are complimentary and serve as a great opportunity to gain further insight by voicing your concerns and having questions answered. During the initial consultation, Dr. Hsu will ask some questions to get to know you and determine if you are a good candidate for a breast lift.

During the consultation, Dr. Hsu will first ask about the area in question, and determine what kind of goals you have for your breasts after surgery. He will make a series of careful measurements to determine your current position of the breasts, as well as their relation to your chest wall. These measurements are a crucial part of the surgical planning, to maximize the results. Dr. Hsu will also ask about your medical history, including existing medical conditions, past surgeries, tobacco usage, daily medications, supplements, and allergies. For patients over 40, we will need your recent mammogram results. Some patients may consider getting a breast augmentation in conjunction with a breast lift. If you have had significant breast size decrease, or you would like more fullness, then an implant can often be placed at the same time as the lift. If you are content with your size and just desire a lift, then a breast lift alone can work very nicely. After the full assessment, Dr. Hsu will determine whether you a good candidate for the procedure. If so, he will explain the type of lift that he recommends for you. If you are also getting a breast augmentation along with the lift, you will be able to choose among a range of sizes that Dr. Hsu will select for you.

There are three different incision methods. Dr. Hsu will go over each of them during the consultation and determine which method is best tailored for you.

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The first most common method is the inverted T or “Wise-pattern” lift (commonly known as the anchor lift) and is used for patients that have a lot of sagging and excess skin. The idea is to place the nipple higher up on the breast and remove the excess skin in several directions. This results in a nicely healed scar around the areola, and then from the areola down to the fold and underneath the breast. Of these incisions, most patients are worried about the vertical scar line, but it generally fades very well over time.

The second method is the vertical lift or colloquially known as the lollipop incision. This method also moves the nipple up to a better position while eliminating the need for the horizontal incision used in the Wise-pattern lift.

The third method is the circumareolar lift, also known as a “donut mastopexy” or a “donut lift” (so-called because a ring of skin is removed around the nipple which is in the shape of an oval-shaped donut). For patients with not much sagging at all, and mostly sagging of the nipple alone, Dr. Hsu will recommend the circumareolar lift. He will take a little bit of skin above the nipple and move the nipple up to an elevated position. This is a nice way to limit scarring since the incision is only around the nipple and can even be done under local anesthesia as a nipple lift (see Mini-Breast Lift section).

If you feel your breasts might also need some volume and are also interested in getting a breast augmentation in conjunction with a breast lift, please see our Breast Augmentation procedure page for more information.

Surgery Details:

On the day of surgery, come in early to fill out paperwork, meet the anesthesiologist, and the staff will prep you for surgery. Dr. Hsu will meet you in the pre-operative area before surgery to make markings on the areas planned for surgery and answer any last questions you may have. 

Breast Lift diagram

The procedure usually takes about two hours and half to three hours to complete for a standard breast lift and about three hours for a breast lift with augmentation. Like most cosmetic procedures, this is an outpatient procedure and you will be able to go home after surgery. During surgery, he will make the agreed upon incision, raise the breast and nipple, and suture everything into place. Dr. Hsu uses a special skin closure technique that involves multiple layers of stitches (all dissolvable) to help achieve the thinnest, most inconspicuous scar.
 

Recovery & Post-operative Instructions:

After the surgery, you will wear a surgical bra for about a week to aid the healing process. It is not recommended to lift elbows above your shoulders, but you can still use your arms for different things. During the recovery period, walking is encouraged to help quicken the healing process and minimize clots. Dr. Hsu will be available 24 hours after and he always gives out his personal cell number if you want to reach him directly with any pressing questions.

It is crucial to  keep the surgical area dry until Dr. Hsu gives his approval to shower. To clean the rest of your body, you can bathe from the chest down. Swelling & bruising will peak about 48 hours after surgery but will then decrease significantly in the first two weeks. Most patients can return to work after two weeks, but many patients return even sooner. The biggest limitation for post-operative patients is driving, which should be avoided while taking pain medication. Patients usually stop taking pain medication after five to seven days and plan their work schedules accordingly. Six weeks is usually an appropriate time to return to most types of exercise and activity.

Dr. Hsu likes to follow patients after surgery for an extended period of time to make sure the patient is satisfied and healing well. Most follow up appointments are scheduled immediately after surgery and for up to a year afterward.
 

Dr. Hsu's view on Breast Lift.

More than almost any other breast procedure, I think that breast lift (mastopexy) surgery requires careful consideration and measurement of the dimensions of the breast in order to decide which method is best used for each individual patient.  As stated above, there are three common methods available for performing a breast lift, and the end-result depends as much on the surgeon’s judgment on which method to use, as it does on the surgeon’s skill in implementing that method.

One of the most common surprises for patients looking for breast rejuvenation when they come to see me is that my recommendation on whether they need a lift, an implant, or both, may be different from what they expected or even originally asked for me.  It’s actually very common for patients to come see me asking for a breast implant and a lift, and after examination, I can tell them that they really only need one or the other.  Alternatively, there are patients who are looking are reluctant to get a lift but are seeking breast rejuvenation, and it turns out that their breasts can benefit from an implant alone.  

These determinations are best made in consultation between the patient and the surgeon.  It’s surprising how much the breast can change with pregnancy, breast feeding, or weight loss, and each patient’s body is different.  Getting the most aesthetically rejuvenated appearance is always the goal, but the approach varies from patient to patient.