Breasts may develop droop (ptosis) with aging, pregnancy, and weight fluctuations, especially weight loss. Genetics, smoking, even sun exposure can affect the amount of ptosis. A breast lift (mastopexy) can be used to correct droop. Multiple procedures exist. Some patients also benefit from some tissue removal (breast reduction) from concurrent placement of breast implants.

Dr. Goldman has developed his own method of adding volume to the central breast using auto augmentation, lifting tissue from the bottom of the breast upward while tightening the lower pole of the breast. This lifts the entire breast but also reshapes it.

Additional techniques are sometimes useful, like fat injection, especially to the upper pole of the breast along with a breast lift. Fat injection cannot provide the volume or shape that a breast implant can, but it can be useful to contour the breast. Laser resurfacing or other techniques can also be used to improve the texture and elasticity of the skin, reduce sun damage, and smooth wrinkles, adding a rejuvenating effect to the lift.

Some patients have had previous surgery, including augmentation, reduction, or even prior lifting. Such revision cases are often more complex and typically require more detailed planning and precise surgical technique to achieve optimal results.

Dr. Goldman is a highly experienced triple board-certified plastic surgeon who individualizes your care based on your needs–listening to your goals and needs and analyzing your specific physical characteristics to determine the best surgical option to achieve your ideal result.

Who is a good candidate for a breast lift?

You can consider a breast lift surgery if:

  • Your breasts have significant droop.
  • Your breasts have lost volume and shape.
  • You have asymmetry, large areolas, and other or additional concerns.
  • Ideal surgical candidates are non-smokers and in good overall health.

Types of breast lifts

Breast lift can be classified based on the incisions that are used or based on how the breast tissue is rearranged. The most commonly used classifications are described below. There are multiple variations, and most surgeons favor specific techniques or nuances. Your surgeon should be able to explain his or her preferences so that you can understand if a specific procedure is the best choice for you.

Periareolar mastopexy (donut lift)

Periareolar mastopexies are ideal for women with mild drooping. This breast lift technique involves making a circular incision around the areola (the pigmented circle of skin around the nipple).

A crescent of breast skin is removed from above the areola, and the nipple and areola are lifted upward. The incision is closed as a circle, concealing the scar in the border between the areola and the surrounding skin. Dr. Goldman uses a soft permanent suture around the areola to limit long-term stretching.

Patients with more significant droop should not use this technique because the circular incision cannot accommodate a large lift without healing as a thick, noticeable scar.

Vertical breast lift

Multiple variations of this technique exist. This procedure involves a circular incision around the areola in order to lift the nipple and areola, as well as a vertical incision beneath the areola. The vertical lift may be referred to as a lollipop lift if no horizontal incision is used. However, a short horizontal incision is often used to help tighten the lower breast.

Dr. Goldman typically moves tissue from the bottom of the breast to the midportion of the breast to create a higher, more youthful appearance. This is referred to as auto-augmentation. Tissue can also be removed from the lowest part of the breast to reduce overall volume, which is ideal for addressing a breast that is bottom heavy. Dr. Goldman also uses liposuction to contour the chest and upper abdomen around the breast, to optimize overall proportions.

The vertical lift can also be combined with a small implant to improve upper pole fullness and increase the overall size of the breast. Patients with significant flattening of the breast (pseudoptosis) often need a small implant. Note that a mastopexy alone will generally decrease the size of the breast slightly, even if minimal tissue was removed.

Fat injection can be used to contour the breast, especially in the upper pole. Fat cannot add as much volume or roundness to the breast as a breast implant.

Inverted-T breast lift

The inverted-T technique is most commonly used for breasts with severe ptosis and excess skin. It adds a horizontal, curved incision just above the breast crease (the inframammary fold). The terminology can be confusing because an inverted-T (upside-down-T) incision can be used with a vertical breast lift as noted above. The main distinction is that in patients with more severe droop, a longer horizontal incision is used.

Addition-subtraction procedure

Dr. Goldman often removes some breast tissue from the central part of the lower breast and adds a subpectoral implant at the same time. The procedure removes the tissue that contributes most to the droop (at the bottom of the breast) and adds volume where it produces the most youthful appearance, perkiness, and projection – in the central and upper breast.

Volume is usually added with a small implant. The patient’s own fat can be injected into the breast, but this does not generally cannot add as much roundness and fullness as an implant.

Implant choice (saline versus silicone, profile, size) is always individualized to the patient’s goals and physical characteristics. Dr. Goldman will help you review the benefits and risks of each option so that you can understand what is best for you.

Saline implants are often a good choice when small implants are needed. Silicone implants are commonly used in patients with thinner, looser tissues and more deflating and flattening.

Internal bra, mesh, or other options

Multiple techniques tried to try to improve internal support for the breast. Although Dr. Goldman does occasionally use dissolving mesh with mastopexy, his technique of auto augmentation uses the breast tissue itself to reshape the breast, which is then supported by the overlying skin.

This is a belt and suspenders type approach means mesh is only needed in certain specific cases, like some revisions, patients who want larger implants, or patients who have markedly loose tissues, especially after massive weight loss.

Expectations after a breast lift

Generally, this is not considered a very painful procedure, but most patients will take a few pain pills over the first couple of days postoperatively. Breasts will typically have moderate bruising and mild swelling after mastopexy. Bruising generally resolves in 2 to 3 weeks, like most bruises.

Dr. Goldman likes his patients to shower in 2 days and resume exercise in 2 weeks. Most patients take less than a week off work. Dr. Goldman does not use drains for mastopexy. Patients are sent home in a Velcro sports bra. This is a same-day surgery procedure.

The incisions generally will look everted (like a small ridge) initially. The areolar incisions are typically pleated, with a purse string effect. The incisions generally smooth out in 1 to 2 months, but they can look a little scary at first. Dr. Goldman uses dissolvable stitches underneath the skin to minimize scarring, so no stitches have to be removed.

Breast lift surgery results

This is a very high satisfaction rate procedure. Even though the breasts generally look somewhat bruised, mildly swollen, and often somewhat tight or flat at the bottom initially, most patients can see significant lift effects and overall enhancement in shape and contour early after surgery.

Patients who have mastopexy alone may notice a decrease in breast size and bra cup size. The more lift is achieved, the more decrease in size may be noted. Some patients do desire additional tissue removal for a breast reduction effect. Breast reduction is a separate topic, but breast lift is an inherent part of a breast reduction.

Many women do desire a reduction in areolar size, which is part of a breast lift for most patients.

Mastopexy does result in changes that are largely permanent. Specifically, the nipples will not significantly descend over time in the vast majority of patients with routine aging. Pregnancy or significant weight loss can cause some descent. However, the skin typically becomes thinner and less elastic, and the breast tissue typically becomes less firm, with aging, so over many years postoperatively, most patients will feel that their breasts do settle or flatten somewhat.

Mastopexy risks

Like any surgical procedure, mastopexy has potential risks and complications. These include:

  • Nipple sensitivity: Changes in nipple sensitivity (numbness or hypersensitivity) can occur after surgery. Most often, these changes are temporary, but in some cases, they may be permanent. Permanent nipple numbness probably occurs in about 15% of mastopexy patients overall.
  • Infection: Although rare, infections can develop after the surgery. Patients only require one dose of antibiotics at surgery for mastopexy by itself.
  • Asymmetry: Achieving perfect breast symmetry is always one of the primary goals of cosmetic surgery, but minor differences in breast shape or position may appear after surgery. Preoperative asymmetries are always identified and addressed at surgery.
  • Delayed healing: Some individuals may experience slower wound healing, potentially leading to wound separation, the need for bandages, or even additional procedures, although uncommon. Areas of delayed healing can have additional scarring.
  • Hematoma: Bleeding after surgery can lead to the occurrence of a hematoma, a blot clot in the wound. This kind of clot cannot migrate to the lung (like a deep venous thrombosis), but a hematoma may require additional drainage in the office or operating room.
  • Skin necrosis: Blood flow changes to the skin can occur after rearrangement of the breast tissue and skin. This can reduce blood flow to certain areas, resulting in the death of the skin. An area of skin may become darker purple, then scab, require wound care, and ultimately have a scar. Smokers have a higher risk of skin necrosis. Young, healthy patients have a low risk.
  • Fat necrosis: Blood flow changes to the breast tissue may similarly reduce blood flow. Fatty tissue may ultimately become replaced with scar tissue. This can feel like a lump or a hardened area of the breast. Workup with mammograms, needle biopsies, or even removal may sometimes be necessary.
  • Partial or total loss of the areolae or nipples: Although rare, necrosis of the nipple or areola can occur. This can lead to deformity and require further surgery. Smokers, patients who have had prior breast surgery, patients with autoimmune disease, or those with severe droop and poor tissue quality are more at risk for this.

Breast lift faqs

Mastopexy surgery time

Generally, the procedure takes 2-3 hours, but this varies greatly depending on what procedure, or combination of procedures, is needed. This is a same-day surgery. Patients are generally discharged within an hour after surgery.

Pain

Mastopexy is performed under anesthesia, so patients are comfortable. Postoperative pain is usually mild to moderate. Most patients only take occasional narcotics for the first 2 to 3 days after surgery. Some patients only use Tylenol. Most patients return to work in less than a week.

The cost of a breast lift procedure

Price varies widely based on what specific procedure, or combination of procedures, is performed. And of course, price varies between surgeons. Breast lifts range from $5000 to $15,000 in general.

Schedule a breast lift consultation with Dr. Goldman

There are multiple different mastopexy techniques as well as additional procedures that may be performed concurrently to achieve ideal results. Knowing which procedure or procedures are right for you can be confusing.

Dr. Goldman and his staff pride themselves on helping you navigate these decisions by listening to your goals and concerns, thoroughly evaluating your medical history, and analyzing the specifics and nuances of your physical characteristics. We help you choose which option is best for you. Feel free to contact us if you have any further questions at (216) 514-8899 or info@drgoldman.com.