Mastopexy: Understanding the Considerations

Mastopexy: Understanding the Considerations

Dr. Constance M. Chen

Plastic Surgeon Dr. Constance Chen with Guidelines for Women Planning on having Breast Lifts.

Breast lifts are most common after pregnancy and as women age. The best way to learn about the best techniques for your body is to consult with a board-certified plastic surgeon. ”

— Dr. Constance M. Chen

NEW YORK, NY, UNITED STATES, August 29, 2023/ — All women’s breasts change with time and gravity. As women get older, it is typical and natural for the skin to lose elasticity and for the breasts to drop. Breastfeeding is the biggest factor, but occasionally some women who did not breastfeed may find their breasts droop over time. Menopause is also a factor because dense glandular breast tissue is replaced by fat, and fatty tissue is softer and less firm. “If a woman is unhappy about sagging breasts, the only way to fix it is surgery,” says plastic surgeon and breast reconstruction specialist Dr. Constance M. Chen. “A well fitted bra can provide support for a better look in clothes but exercises to firm the underlying chest muscles won’t impact the breast tissue itself. Ultimately, if a woman wants perkier breasts she needs to meet with a plastic surgeon to discuss the options for a breast lift.”

A breast lift (or “mastopexy”) is a procedure in which excess skin is removed to tighten the breast envelope and which also repositions the breast tissue and the nipple-areola complex higher on the chest wall. Most often a mastopexy will not change the size of the breasts, even though the result may make the breasts appear fuller and rounder. In cases where a woman wants larger or smaller breasts, additional procedures such as augmentation or reduction can be done in conjunction with a breast lift.

In many cases, women who pursue a mastopexy have nipples that point downward, particularly if they sit lower than the crease below the breasts. This can happen because the tissue falls to the bottom of the breast leaving the top of the breast appearing flat and empty. Dr. Chen advises that there are several different mastopexy procedures depending on the degree of lift needed.

A “crescent lift,” is the least invasive procedure. In this case a crescent of skin at the top of the nipple-areola complex is removed to improve the position of the nipple. The crescent lift is called for when the breasts are basically perky but the woman wants her nipple-areola complex adjusted upwards slightly. In cases where a woman also want bigger breasts, the crescent lift can be performed in conjunction with breast augmentation.

A “Benelli lift” is also used to provide a small lift on barely drooping breasts. Here a doughnut-shaped incision is made around the nipple-areola complex, and the skin is tightened. While this kind of breast lift is less invasive than a full lift, it can have the side effect of flattening the breast. An implant can be used to improve the projection of the breast.

A “lollipop lift” or a short-scar vertical mastopexy is used when the breast tissue itself needs to be positioned higher on the chest wall. The short-scar vertical mastopexy refers to the limited scars around the nipple-areola complex and then vertically to the fold below the breast which look like a lollipop. In this procedure more breast skin is removed, and the underlying breast tissue is repositioned to significantly change the breast shape and lift it up.

An “anchor lift” or the traditional Wise-pattern mastopexy adds a horizontal scar along the crease below the breast to the same scars of the vertical mastopexy to allow for reshaping and repositioning the tissue. This is an older procedure used by older surgeons not trained in the vertical mastopexy who are particularly prone to using it when there is significant sagging in large breasts.

The vertical and the Wise-pattern mastopexies are both full breast lifts that are equally effective in creating a perkier and more youthful result. The vertical mastopexy is also called the “short-scar mastopexy” because it eliminates the horizontal scar in the inframammary fold. It is an improvement on the anchor lift. Full mastopexies are the most commonly performed breast lifts because it is usually the appropriate technique for someone who wants a noticeable change to their breast appearance.

Most breast lifts are performed on an out-patient basis with patients encouraged to walk as soon as possible after surgery. In larger breast lifts, patients will have drains for 1-2 weeks after the procedure. In typical cases, women can return to work after a couple of weeks and begin to feel more normal about 4-6 weeks after surgery. Patients are encouraged to avoid heavy lifting right after surgery, but unrestricted activity can usually begin again between 6-8 weeks. The final result can take months or even years to evolve. Candidates for mastopexy should be in good physical health, non-smokers, and have a BMI less than 30 to minimize the risk of wound healing problems and infection.

Breast lifts are most common after pregnancy and as women age. The best way to learn about the best techniques for your body is to consult with a board-certified plastic surgeon. Woman today have many safe options for improving their breasts to feel more comfortable in their bodies.

Constance M Chen, MD, is a board-certified plastic surgeon with a special expertise in the use of innovative natural techniques to optimize medical and cosmetic outcomes for women undergoing breast and body restoration. She is Clinical Assistant Professor of Surgery (Plastic Surgery) at Weill Cornell Medical College and Clinical Assistant Professor of Surgery (Plastic Surgery) at Tulane University School of Medicine.


Melissa Chefec
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