Breast Lift (Mastopexy)

Mastopexy lifts and tightens the breast by removing loose skin and reshaping the tissue beneath it. It corrects sagging and repositions the nipple. It does not increase breast volume.

Breasts descend with age, with weight loss, and with the hormonal cycles of pregnancy and breastfeeding. Gravity stretches the supporting ligaments, and fluctuation in weight reduces the firmness of the skin.

An auto-augmentation technique is used to restore fullness in the upper pole of the breast. Mastopexy can be combined with augmentation where added volume is wanted, or with reduction where the breast is also too large.

Who it suits

• Patients in good health at or close to a stable body weight
• Patients whose breasts have lost firmness and substance, sit below the inframammary fold, and whose nipples and areolae point downwards
• Patients seeking correction of asymmetry, where one breast differs markedly in size or shape from the other

The four stages of breast ptosis

The degree of ptosis is defined by the position of the nipple relative to the inframammary fold, and it determines which technique is appropriate.

Grade I — mild ptosis The nipple remains at the level of the inframammary fold.

Grade II — moderate ptosis The nipple sits well below the inframammary fold.

Grade III — severe ptosis The nipple lies at the lowest part of the breast tissue and points towards the floor.

Pseudoptosis (glandular ptosis) The nipple is at or above the level of the inframammary fold, but the majority of the breast tissue lies below it.

Types of breast lift

Each technique uses auto-augmentation, creating a pocket in the upper pole and rotating the nipple and areola upwards so that the breast sits higher on the chest.

Crescent or periareolar

Effective for mild ptosis where the nipple needs raising by one to two centimetres and the shape of the breast needs little change. The incision runs around the areola at its junction with the breast skin. It can be added to an augmentation for minor repositioning, and is used in the correction of tubular breasts with puffy nipples and enlarged areolae. The scar blends into the darker edge of the areola.

Vertical, or “lollipop”

Suited to moderate ptosis where the nipple needs to move several centimetres. The incision encircles the areola and runs down the front of the breast to the crease, forming the shape of a lollipop. The larger incision gives greater access to the breast tissue, allowing more reshaping and more skin removal. Scarring is limited and recurrence of sagging is less likely.

Inverted-T, “anchor”, or Wise pattern

Used for naturally large breasts with severe ptosis, considerable excess skin or lax tissue. The incision circles the nipple-areola complex, runs vertically from the base of the nipple to the inframammary fold, and then horizontally along the length of the fold. It gives the greatest access to the tissue and allows skin to be removed in more than one direction, producing the largest change in nipple position and breast shape.

Recovery

A surgical bra is worn to reduce swelling and support the breast while it heals. Small drains are placed at the sides of the breasts to remove excess blood and fluid; they are removed the following day, which is not painful.

Bruising, swelling and tenderness are expected and are managed with prescribed oral pain medication. Rest for the remainder of the day of surgery, then begin light walking soon afterwards. Non-strenuous activity resumes after two weeks; exercise and aerobic activity are avoided for four weeks. Around one week of downtime is usual, with one to two weeks away from work depending on occupation.

Over the following months the shape and position of the breast settle and the scars fade. Some patients notice a slight difference in shape or size between the two sides early on, as they heal at different rates.

After surgery — do

• Rest and take the prescribed pain medication
• Wear only the type of bra the surgeon has recommended
• Sleep on your back or side, avoiding pressure on the breasts
• Attend follow-up appointments
• Arrange help at home for the first few days
• Protect the breasts from pressure and compression
• Keep the breasts out of direct sunlight

After surgery — do not

• Lift, push or undertake intense activity in the early weeks
• Ignore the post-operative instructions
• Smoke
• Expose scars to the sun
• Sleep on your front
• Wear ordinary bras
• Take blood thinners

Longer term

The results of a breast lift are lasting. Changes in body weight and the loss of skin elasticity with age can alter the appearance over time, and maintaining a stable weight preserves the result. Mastopexy does not prevent breastfeeding or future pregnancy, though the hormonal changes of pregnancy may change the shape of the breast.

Where the surgery takes place

Dr. Stavrou performs mastopexy in accredited medical centres in Cyprus, Greece and Malta. After the procedure the patient is transferred to the recovery suite and monitored by the clinical team.