BREAST LIFT (MASTOPEXY)

Dr Chia Hui Ling

A breast lift, or mastopexy, repositions and reshapes breast tissue that has drooped over time, raising the nipple position and tightening the surrounding skin envelope. It addresses shape and position rather than size, so many people considering a lift also weigh up whether they want added volume at the same time.


•      Raises the nipple and areola to a more youthful position on the chest

•      Tightens loose or stretched skin for a firmer, more supported contour

•      Improves the appearance of breasts that have changed after pregnancy, breastfeeding, or weight loss

•      Can be combined with an implant if you also want more volume, or performed alone if size is already adequate

•      You have noticeable sagging, with the nipple sitting at or below the breast fold

•      You are bothered by loose skin or a deflated look rather than by breast size itself

•      You are finished with childbearing and breastfeeding, or accept the scars may need revisiting after future pregnancies

•      You accept permanent scars in exchange for a lifted contour

•      You are in good general health and a stable weight



A lift changes shape and position, not volume, so if you are hoping for noticeably larger breasts as well, this is worth discussing openly, since it usually means adding an implant.


Grades of Breast Ptosis 


Mastopexy surgery addresses the problems of breast ptosis by removing excess loose breast skin and reshaping the breast tissue (parenchyma). The removal of breast skin will result in scars. In general, more skin removal will give rise to longer / more scars. The scars are placed strategically around the areolae, along the breast crease and down the lower vertical axis of the breast. 
 

TREATMENT

Mastopexy is performed under general anaesthesia, typically as day surgery, though the exact technique depends on how much sagging is present.



•      Mild sagging may only need an incision around the areola

•      Moderate sagging often uses a vertical (lollipop) pattern

•      More significant sagging may require a full anchor-shaped incision

•      Internal breast tissue is reshaped and lifted, not just the skin envelope

•      Surgery typically takes two to three hours

•      Most people take one to two weeks off work

•      Swelling and firmness settle over six to eight weeks

•      A supportive bra is worn for several weeks after surgery

•      Scars are pink and firm initially, softening over twelve to eighteen months

•      Strenuous exercise is usually restricted for around four to six weeks


Mastopexy Scar Patterns

Augmentation Mastopexy


In mild cases of breast ptosis, breast augmentation with implants alone can offer a modest breast lift without the need for a mastopexy. 


Breast deflation often accompanies breast ptosis and an augmentation mastopexy is suitable for those looking for both a breast lift and an increase in breast volume. Breast augmentation and mastopexy are often carried out together in the same setting, but some plastic surgeons may elect to stage the augmentation mastopexy and do them on separate occasions. Fat grafting is another option to augment the breast in a mastopexy.


  • Preparing for Surgery

    Do inform your plastic surgeon of previous breast conditions and surgeries, any medical conditions and medications. If you are approaching or more than 40 years of age, preoperative breast screening is recommended. Avoid blood-thinning medications, anti-inflammatory drugs or herbal supplementations as they can increase the risk of excessive bleeding during surgery, unless indicated by your doctor.



  • Surgery

    The surgery is usually perfomed under intravenous sedation or general anaesthesia, and often in a day surgery.


    The plastic surgeon starts with marking of the breasts in a standing or sitted position before the surgery. During the surgery, the excess skin is removed, breast tissue (or parenchyma) is reshaped and the nipples are lifted. 


    If an augmentation mastopexy is planned, implants are placed to augment the breasts at the same time.  Sometimes, the surgeon may stage the augmentation and breast lift surgeries and perform them on separate occasions. 


    Another option to increase the breast volume is to perform fat grafting with mastopexy. Fat is harvested from other areas of the body, processed and injected into deficient areas of the breasts.


  • Post-Surgery Care

    You may be asked to wear a support bra after surgery. The breasts will be more lifted and swollen straight after surgery and this will settle to a more natural shape over the next few months.

COMPLICATIONS AND MANAGEMENT

Mastopexy is generally a well-tolerated procedure, but it carries risks common to breast surgery, along with some specific to lifting and reshaping tissue.



•      Permanent scarring around the areola and, depending on technique, down to and along the breast fold

•      Temporary or, less commonly, permanent changes in nipple sensation

•      Asymmetry in shape, size, or nipple position

•      Delayed wound healing, particularly where incision lines meet

•      Some recurrence of sagging over subsequent years, as gravity and ageing continue

•      Rarely, reduced blood supply to the nipple in more extensive lifts, which can affect healing


FAQs

What is the difference between a lift and an augmentation?

A lift repositions existing tissue and tightens skin to address sagging, while augmentation adds volume with an implant or fat. Many people with both sagging and volume loss choose to combine the two.

Will a lift make my breasts bigger?

No, a lift on its own does not add significant volume, and may even appear to reduce fullness slightly as excess skin is removed. If you want more size as well, this is usually addressed with an added implant.

How long will the results last?

Results are long-lasting but not permanent, since gravity, ageing, and weight changes continue to affect the breasts. Many people enjoy a lifted appearance for many years before any noticeable change.

Will I be able to breastfeed after a lift?

Most techniques aim to preserve the ducts and nerve supply to the nipple, so breastfeeding ability is often retained, though it cannot be guaranteed for every patient.

Can I combine a lift with an implant in one surgery?

Yes, this is common when there is both sagging and a desire for more volume, though it is a longer procedure with a somewhat higher combined risk profile than either alone.

When will I see my final result?

Initial shape is visible within a few weeks, but swelling continues to settle over two to three months, with scars maturing over the following year or so.