Breast Lift (Mastopexy)
Aging, genetics, pregnancy, nursing, weight loss, and gravity have adverse effects on women’s breasts, causing them to lose their elasticity, firmness, and shape. Using advanced procedures, we can correct these conditions at our nationally-accredited (AAAASF) on-site office surgical facility. Loose or sagging breast skin may cause the nipple/areola complexes to point down, or be positioned below the inframammary breast creases. Breast lift (mastopexy) surgery involves removing excess breast skin and then tightening the remaining tissues to produce a firmer and shapelier breast contour. Nipple/areola position is more perky and youthful, and stretched areola size can be reduced as well. If desired, sagging breasts can not only be uplifted, but size can be increased via breast lift plus implants.
Candidates for Breast Lift Surgery
The best candidates for a breast lift (mastopexy) are healthy women who have adequate breast volume (size), would like to achieve a more youthful and uplifted breast appearance and self-confidence, but are realistic about the incisions and resultant permanent scars that are necessary to produce these improvements. The best results are achieved on women with sagging breasts due to loss of skin elasticity because of pregnancy, breast-feeding, or weight loss. Women whose breast size is normal will need only breast lift (mastopexy), but women with larger breasts may choose breast reduction to both lift and reduce size to a more youthful, proportionate appearance. Smaller breasts with loose skin as well as loss of volume may look flattened or deflated, and breast lift plus implants can restore both shape and size.
Breast droop or sag (ptosis) can be mild or severe, and several incision patterns are available to deal with each of these. Of course, the goal is always to perform as much lift as is necessary to achieve a beautiful result with as few incisions and scars as possible. Unfortunately, some surgeons believe that they are always able to accomplish more lift with minimal lifting incisions, and since patients want this as well (along with fewer scars and less cost), this certainly seems to be an easily agreed-upon way of thinking. However, the incisions needed to give the most powerful lift and beautiful shape must often be more extensive, making the skill and precision of the surgical closure a very important issue. Both Dr. Tholen and Dr. Gervais use only below-the-skin dissolving sutures for virtually all of their breast lift operations, with no external sutures or staples to cause unsightly scars!
Breast lift surgery is performed by both American Board of Plastic Surgery-certified plastic surgeons at Minneapolis Plastic Surgery, LTD. Prior to surgery, careful measurements and markings are made on the patient’s breasts, allowing creation of a new skin brassiere in one of several individualized patterns discussed at the time of consultation. Incision patterns are designed to create the most pleasing breast shape with the least possible scarring. During the breast lift procedure, excess skin is carefully removed via incisions around the areolas and along the undersides of the breasts. The nipple/areola complexes and breast tissue are not detached, but are elevated along with the breast glandular tissue to a higher point on the patient’s chest. If desired, breast implants may be used to restore breast volume lost by breast-feeding or weight loss in a combined breast lift/breast augmentation (breast lift plus implants) procedure.
Although there is an incision around each areola, the nipple/areola complex remains attached to the breast ducts and tissue, which usually preserves nipple sensation as well as the ability to breast-feed. Nipple sensation can be lost in about 15% of patients who have breast lift or breast reduction surgery. All of the incisions are closed with dissolving sutures below the skin surface; this eliminates crosshatch marks or unsightly railroad-track scars. The breast lift scars fade and soften over several months after surgery; the plastic surgeons and nursing staff at Minneapolis Plastic Surgery, LTD. will provide additional information about what you can do to reduce scar visibility. Since the scars are all below the breast or around the areolas, most bathing suits and clothing can be worn without exposing scars, including V or revealing necklines.
Lesser degrees of ptosis (sagging) can be successfully treated with implants alone (breast augmentation), or by other incision options, such as periareolar (donut mastopexy or Benelli circumareolar) lift, or vertical lift (“lollipop” or circumvertical mastopexy). While every “short-scar” or “limited-incision” breast lift sounds attractive because of reduced scarring, successful skin tailoring to create a shapely skin brassiere and aesthetically-beautiful result may require additional incisions. Attempting limited-incision lifts when more detailed and extensive skin tailoring is necessary for the best-shaped breasts only leads to poor cosmetic results (including funny shapes and stretched or unsightly scars), and re-operation. We can discuss the pros and cons of each of these breast lift choices, and will advise you as to the best options for each woman’s anatomy and goals.
Although complications are possible with any surgery, breast lifting has one of the highest patient satisfaction rates, similar to breast reduction surgery. Most complications are rare and easily treated. Careful surgery, as well as compliance with post-operative instructions, reduces the likelihood of any complication. Every patient should avoid aspirin or ibuprofen-containing medications for two weeks before and after surgery, as these medications can increase the risk of bleeding and re-operation. Vitamin E and herbal medications or supplements should also be avoided as these too can cause bleeding or interfere with anesthesia.
Most importantly, breast lift patients must not smoke or use any kind of nicotine product (patches, spray, e-cigarettes, or nicotine gum) for two weeks before and after surgery, as nicotine can cause serious circulation problems in the lifted breast skin. If the circulation is impaired past a critical degree, breast skin or nipple/areolar skin can lose adequate blood flow to survive, causing dead skin or fat necrosis, requiring prolonged dressing changes, skin graft, or additional revisionary surgery, as well as significantly increased scarring. Even one cigarette or exposure to second-hand smoke can increase these risks to as high as 15-20 percent. Increased scarring or poor healing can result from poor circulation even in non-smokers, though this is rare.
Infection following breast lift surgery, or breast lifting with implants, is exceedingly rare, but is possible with any operation. Antibiotics are given just before your surgery, and antibiotic/antiseptic irrigation is done during surgery. Oral antibiotics after surgery further reduce the risk of infection. Care of the incisions after surgery, and avoidance of contact with pets will be necessary, and you will be given detailed information during your follow-up visits to assist you in an uneventful recovery.
Most women have some degree of breast asymmetry naturally, and absolute symmetry is both unrealistic and impossible after breast lift surgery. If you have more noticeable asymmetry (including absent or unevenly-developed breasts), or simply breast-fed more on one side than the other, each breast (or only one) can be lifted in a specially-tailored pattern to improve symmetry to a marked degree.
Recovery and Results
During the first few weeks after surgery, breast lift patients should carefully follow all of the instructions provided for them by our surgeons. Women resume normal everyday activities within a day or so, and can usually return to work in several days provided that their occupation does not involve heavy lifting or other physically vigorous activity. Patients should avoid strenuous activities, exercise, or sleeping on their stomachs for the first two to three weeks to avoid bleeding, stretch on suture lines, and to ensure that the breasts heal properly. Swelling and bruising is generally mild, and over time, the breasts will heal with their new more uplifted position. Post-operative discomfort is usually not severe, and is easily managed with prescription medications for pain and inflammation. Some after-surgery numbness in the breast skin is normal, and sensation will gradually recover over several months as sensory nerves heal, but will not always return to full preoperative sensibility. As mentioned earlier, about 15% of patients may experience loss of sensation in one or both nipples.
As time goes on, the final results of breast lift surgery will emerge and scars will fade. Breast lift surgery produces natural results that can vastly improve the overall appearance of a woman’s figure.
Cost for Breast Lift (Mastopexy) Surgery
Total cost for breast lift surgery in Minneapolis Plastic Surgery’s nationally-accredited (AAAASF) on-site office surgical facility, is around $9100. In some cases, women may request deflated and sagging breasts to be restored to a more youthful position as well as increased in size; total cost for breast lift plus implants is around $11,800 with cohesive silicone gel implants; this includes the additional time required to place implants at the time of full breast lift. Exact costs are always given at the time of complimentary consultation with our American Board of Plastic Surgery-certified plastic surgeons. Cash discounts and financing options are available.