Breast Uplift, also known as Breast Lift or Mastopexy, is a surgical procedure to correct breast ptosis or sagging.
A woman’s breasts change in size, volume, and position on her chest throughout her life. Breast ptosis or sagging is a natural consequence of ageing due to loss of skin elasticity, but the rate at which the breasts droop and the severity of the ptosis depend on many factors such as smoking/lifestyle, number of pregnancies and significant weight gain and loss. Furthermore, in younger women with large breasts and poor skin elasticity, sagging may occur early in life due to the effects of gravity, primarily caused by the volume and weight of the breasts which are disproportionate to her body size.
The goals of Breast Uplift surgery are to create improved projection and a more youthful, uplifted appearance while minimising visible scarring. In addition to reshaping the breast, mastopexy can also reduce the size of the nipple-areola.
Breast uplift (Mastopexy) can be performed in any size breast, however very large breasts may be more suited to a Breast Reduction procedure. Subsequently Patients with relatively small breasts and minimal ptosis may be candidates for modified procedures requiring less extensive incisions.
Women with small breasts and upper pole flatness may benefit from simultaneous Breast Augmentation alongside Breast Uplift. The implant can enhance breast size and contour whilst increasing the longevity of the uplifting effects .
Why do breasts sag?
- Loss of skin elasticity with age
- The natural effects of gravity
- Loss of breast volume following weight loss
- Changes in breast size associated with pregnancy and breast-feeding
Best candidates for Breast Uplift / Mastopexy are those who:
- Are happy with the size of their breasts, but consider them to be droopy or pendulous
- Would like to restore breast symmetry following mastectomy, breast reconstruction or sagging following removal of breast implants
- Are healthy, emotionally stable and have realistic expectations about what the surgery can accomplish
- Look for improvement and NOT perfection in their physical appearance
- Understand that uplift only enhances breast shape and will not change their social situation
- Consider their breasts to be both too small and too saggy, in which case would require breast implants as well as uplift
Contraindications to Breast Uplift / Mastopexy surgery
- Certain severe systemic illnesses
- Patient with severe psycho-social issues
- Patient with grossly unrealistic expectations, or body dysmorphic disorder
What to consider at this stage
It is important that before you see Mr Rezai, you consider what you are trying to achieve from your Breast Uplift surgery. In particular, you must decide whether you just want your breasts lifting, or whether you wish for your breasts to be made larger as well. It is also important to take into consideration plans for future pregnancies as pregnancy and breast feeding can change the shape of breast tissue and once again result in sagging breasts.
Consultation, Medical History and Physical Examination
The importance of the initial consultation cannot be overemphasised. Evaluation of anatomic features and determining the degree of breast ptosis is essential when planning breast uplift surgery as it will indicate which technique is best suited to achieve the optimal result.
At your consultation, Mr Rezai will fully discuss every aspect of your aesthetic goals and address any concerns you may have; he places the utmost importance on providing his patients with all the information they need to make fully informed decisions, ensuring each one arrives at the outcome that’s best for them.
Your medical history will be discussed with you. It is important that you answer all questions as honestly and accurately as possible as failure to do so can have significant clinical repercussions. Please feel free to bring along any medical records that may be pertinent to the discussion. Also, it is important to alert Mr Rezai to any allergies or health issues you may have, along with a record of what medicines or vitamins you are taking and whether or not you smoke.
Routine blood tests are required for all patients, about 2 weeks prior to the surgery and a urine pregnancy test will also be performed in most cases, at the hospital on the day of surgery. An ECG is also required for patients over 50 years of age.
During the initial consultation, a relevant physical examination will be performed and various anatomical measurements will be taken to determine the level of ptosis (sagging) and to form the basis for the type of surgical technique required to achieve the best possible results. Breast volume is also an important consideration when planning an uplift procedure, sometimes, when enough breast tissue is not present to achieve an aesthetically pleasing appearance or you simply wish to increase the volume of your breasts as well as reshaping them, breast implants may be used in conjunction with uplift.
Working together during your consultation, a bespoke surgical plan will be developed for you. Mr Rezai will explain in detail the treatment options available, the techniques that would be used, and any potential risks and complications you need to be made aware of. Informational brochures and fact sheets explaining each procedure will be provided for your review. Mr Rezai will use his expertise and experience to guide you towards the best option, taking into account your anatomy, aesthetic goals and personal circumstances.
The Degree of Breast Ptosis (Breast Sagging)
The severity of breast ptosis is determined by evaluating the position of the nipple relative to the infra-mammary fold (the point at which the underside of the breasts attach to the chest wall). In the most advanced stage, the nipples are below the fold and point towards the ground.
As with most surgical procedures, there are many options, depending upon the patient’s wishes, technical considerations. In Breast Uplift surgery, the primary focus is to correct the breast ptosis by removing excess skin and repositioning the nipple-areola hence altering breast volume and contour.
There are several techniques available to correct sagging breasts. The technique is selected based on the degree of the breast ptosis. The severity of breast sagging is categorised by evaluating the position of the nipple relative to the fold beneath the breast, known as the infra-mammary fold, the point at which the underside of the breast attaches to the chest wall. Plastic surgeons use the Regnault Classification to determine the degree of ptosis.
- Type I is Mild ptosis – The nipple areola is situated at the level of the infra-mammary fold and above most of the lower breast tissue.
- Type II is Moderate ptosis – The nipple areola is situated below the infra-mammary fold but higher than most of the breast tissue.
- Type III is Severe ptosis – The nipple areola is situated below or well below the infra-mammary fold and at the level of maximum breast projection. Sometimes the nipple even points downwards.
- Pseudoptosis – Is not a true ptosis as the nipple areola sits either at or above the infra-mammary fold but the lower half of the breast sags below the fold. This is most often seen when a woman stops nursing.
- Parenchymal Maldistribution – This involves a lack of fullness in the lower portion of the breast, a high infra-mammary fold and a relatively short distance from the fold to the nipple areola. This condition is usually a developmental deformity and is also known as tuberous breast.
Surgical Options for Sagging Breast Correction
The common surgical options for correction of ptosis are:
- Breast Augmentation – This option is suitable for women with Type I, mild ptosis or those that have pseudoptosis (the condition in which the nipple is located either at or above the infra-mammary fold, and the lower half of the breast sags below the fold). In these patients, minimal elevation of the nipple areola is required.
- Breast Uplift using Peri-areolar incision technique –The peri-areolar technique involves a crescentic excision and lift of the nipple areola. It produces the shortest possible scar and is well hidden within the nipple areola. This option is again best suited for women with type I, minor degree of ptosis requiring minimal elevation of the nipple areola.
- Breast Uplift using Circum-areolar incision also known as the “Benelli” technique – The circum-areolar technique involves an incision around the areolar, and is best suited to correct mild to moderate ptosis where the nipple areola requires minimal to no elevation. This technique is also used to reduce the size of the areola in Areola Reduction and Tubular Correction surgeries.
- Breast Uplift using the “Keyhole” or “Lollipop” incision technique – The Keyhole / Lollipop uplift is required to correct moderate to severe breast ptosis, such as types II & III, where the nipple is below the level of the infra-mammary crease. This technique involves an incision around the nipple areola and vertical running from the areola to the infra-mammary crease.
- Breast Uplift using the Inverted T or Anchor incision technique – The inverted T technique is required for patients with significant ptosis, very full lower breast poles, or those who require a long transposition of the nipple areola. In this method a keyhole incision is made around the nipple areola and vertical, running from the areola to the breast crease then continuing horizontally along the crease.
If you decide you also want your breasts made larger, then at the same time as the uplift, implants can be inserted into your breasts. The size and types of these implants will be discussed with you at consultation. Please be aware that to achieve the best possible outcome, especially in types II-III ptosis, a two-stage procedure may be necessary (first the uplift then the implants). Please visit our page about Breast Uplift with Implants / Augmented Mastopexy for detailed information.
The procedure for Breast Uplift / Mastopexy surgery
- The operation is performed under general anaesthetic
- It takes about sixty to ninety minutes
- Most patients stay in hospital for one night
- If your occupation is not physical, you can expect to return to work after one week
- Expect to be back to normal physical exercise within four to six weeks
Following the operation
Following surgery some bruising and soreness is expected. The breasts will be firm and swollen at first, and will take several weeks to months, depending on the individual patient’s healing process, to settle and adopt a more natural position.
You may be asked to sleep on your back, and to avoid straining or bending for a few weeks. You are also required to wear a surgical support bra continuously for six weeks, with exception of one hour per day. During the first week after surgery, activities should be restricted as otherwise it will result in unnecessary complications. Most patients resume normal activity after one week. Exercise and strenuous activity should be resumed no sooner than 6-7 weeks after your operation.
There will also be scarring and the extent, will depend on the type of technique used. As with all scars, they will fade over time – in many women, they heal to form very faint white lines. However, it is important to remember that no surgical scar ever totally disappears.
Mr Rezai and his team will provide you with detailed post-surgery instructions to expedite your recovery. Should you develop any doubts or concerns following your treatment, however, they would encourage you to contact them straight away.
Mr Rezai will see his patients for regular post-op follow ups and will guide and advise them on what to do at each stage to improve and maintain their results and how to identify possible complications if they were to develop.
Risks and Complications
Cosmetic surgery is amongst the safest of surgical operations. However, all patients must understand and accept that no such procedure is absolutely free from risk. Mr Rezai will discuss these risks with you at consultation.
For further information concerning the risks and complications associated with Breast Uplift, please refer to Risks and Complications of Breast Uplift.
How long will the results of your Breast Uplift last?
For the great majority of women, the results last for very many years.
Factors that may reduce this period include:
- If surgery was had at a younger age.
- Heavier breasts tend to sag again somewhat earlier.
- Pregnancies will alter the shape of the breast and result in recurrent ptosis.
- Women who opt for larger implants (if they choose the combined procedure).
- Significant weight fluctuation following surgery.