Mastopexy or breast lift surgery refers to a group of elective surgical operations designed to improve the appearance of the breast. Aging, weight loss, and childbirth can lead to a loss of volume and tone of the breast causing sagging or drooping, also referred to as breast ptosis. A breast lift is a proven, effective way to elevate the breast on the chest wall, reposition the nipple and areola (the pigmented area around the nipple). A breast lift may be done alone or in combination with enlargement of the breast for patients seeking additional volume of the breast. When implants are used as part of the procedure, the procedure is known as a breast augmentation.
Techniques for the correction of sagging breasts have evolved over time. A formal or full breast lift is the most extensive with respect to scarring. It is widely used because of the resulting in an uplifted, pleasing shape of the breast. Over time, procedures with more limited scars have been developed in an effort to reduce visible scarring while achieving the best result for the patient. There are several variations of modified or limited scar breast lifts. The recommendation on which procedure is best will depend on the amount of volume and shape of the breast together with an assessment of skin quality and tone.
Full breast lift
The formal mastopexy or full breast lift involves an incision
along the crease underneath the breast, incisions around the areola
, and a vertical incision between the areola and the base of the breast. This incision is sometimes called an "anchor
incision" as well as the "inverted T" because of its shape. This traditional technique is still widely used today because it consistently produces a great shape and position of the breast on the chest wall. In this technique, excess skin is removed, the breast is elevated and frequently, the size of the areola is reduced. This approach allows maximal change to the breast.
The scar is in three distinct locations that each have a characteristic pattern of healing. In the peri-areolar area, scarring is partially concealed by the change in color at the transition from breast skin to the pigmented skin of the areola. The vertical incision from the areola to the crease may be hidden in shadow. The inframammary portion of the scar, along the fold created by the breast is often the thickest of the scars, but it may be hidden in the inframammary fold
. While the scars will always be visible, in most cases the scars fade acceptably and patients are highly satisfied with the results.
Modified breast lifts
The goal of aesthetic surgery has always been to achieve the best results with the most minimal scarring. Over time, modified or limited breast lifts have been developed. These techniques use fewer incisions than the full procedure. A popular form of the modified breast lift is the Benelli breast lift, otherwise known as the concentric
mastopexy also known as the "donut" breast lift. In this procedure, a ring of skin is removed from around the areola and therfore the scar is limited to around the areola
. Another variation of the "donut" is the "crescent" mastopexy which also only removes tissue from around the areola but more tissue is taken from the area above the aroela. This technique raises the nipple and areola on the chest wall.
Another limited scar breast lift is the so call "lollipop lift". In this procedure, the incision is made around the nipple and areola as well as extending down vertically to the crease underneath the breast. Yet another variation consists of the "donut lift" together with the removal of excess skin from underneath the breast.
An advantage of these procedures is less scarring. The potential drawback is that there can be less change made to the breast's shape. Modified mastopexies are frequently done together with breast augmentation.
Length of effects
Breast surgery techniques continue to evolve over time. Breast lifts can improve the position, shape and distribution of existing breast tissue. It must also be remembered that effects of gravity and aging will continue and that some amount of sagging may gradually recur over time.
When considering breast lift surgery, patients should be fully informed as the risks as well as the associated alternatives, benefits and the complication of the procedure. A well trained and experienced plastic surgeon will be able to determine the technique best suited to the patient's particular body type and aesthetic goals.