Breast Lift Surgery (Mastopexy): Everything You Need to Know

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A mastopexy, or breast lift, is a surgical procedure that lifts and reshapes sagging breasts by removing excess skin and tightening supporting tissue. Since a breast lift will not alter breast size, this surgery is sometimes combined with a breast augmentation or reduction procedure.

Breasts wrapped in surgical bandage


Piotr Marcinski / EyeEm/Getty Images

As with any surgery, there are risks involved with undergoing a breast lift. The recovery process, while relatively short, also requires a commitment to post-surgical care for optimal results.

If you are considering a breast lift, learning about what the surgery entails from start to finish is a good first step.

What Is a Mastopexy?

Mastopexy is an elective procedure that may be performed under general anesthesia or in select patients, local anesthesia with intravenous sedation.

During the operation, the surgeon removes excess breast skin and then tightens, lifts, and reshapes the surrounding breast tissue. The nipple and areola are also repositioned higher up.

Since mastopexy is considered a cosmetic procedure, it's not usually covered by insurance. The average cost of a mastopexy is around $10,000 to $14,000, plus anesthesia and operating room fees.

Various Surgical Techniques

There are many different surgical techniques used to perform a mastopexy. The chosen technique depends on factors like your breast size and shape, areola size and position, degree of breast sagging, and how much extra skin needs to be removed.

  • Vertical or "lollipop" lift: This technique involves two incisions—one around the perimeter of the areola, and one that goes vertically from the bottom of the areola to the breast crease (the area where the breast meets the chest). This technique is used for women with a moderate degree of sagging who do not want breast implants.
  • Inverted T or "anchor" lift: This technique involves three incisions—one around the perimeter of the areola, one that goes vertically from the bottom of the areola to the breast crease, and one that runs horizontally along the breast crease. This technique is suitable for patients with substantial sagging as it allows for an ample amount of excess skin to be removed. It's often used in conjunction with a breast reduction.
  • Peri-areolar or "donut" lift: This technique involves a circular incision around the perimeter of the areola. It's suitable for patients experiencing mild-to-moderate sagging and is commonly performed along with a breast augmentation.
  • Crescent lift: This technique involves an incision running halfway around the top perimeter of the areola. It's suitable for patients who have a very small amount of sagging to correct and is usually only done when a patient is also having breast augmentation.

Scarless Breast Lift

Some plastic surgeons are able to perform a scarless breast lift in select patients with mild sagging. Instead of a scalpel and surgical incisions, the surgeon uses radiofrequency energy to tighten the breast tissue.

Contraindications

Relative contraindications to a mastopexy include:

  • Severe medical conditions (e.g., bleeding disorder, obesity, or uncontrolled diabetes or hypertension)
  • Current smoker
  • Prior bariatric surgery with a nutritional deficiency (may be addressed and corrected)
  • Unrealistic goals or expectations

While not necessarily a contraindication, be sure to talk with your physician if you are planning on becoming pregnant in the future. Pregnancy can unpredictably change your breast size and shape, so the results of your surgery may be affected.

Potential Risks

Besides the known risks of anesthesia and surgery (e.g., blood clots, bleeding, and infection), specific risks associated with a mastopexy include:

  • Breast hematoma
  • Breast asymmetry and contour/shape deformities
  • Changes in the sensation of nipple or breast (either temporarily or permanently)
  • Breast seroma
  • Skin and partial or complete nipple loss
  • Delayed wound healing or dehiscence
  • Scars
  • Recurrent breast droopiness
  • Inability to breastfeed

Purpose of Breast Lift Surgery

Breasts consist of both fatty and glandular tissue. In younger women, glandular tissue dominates, which gives breasts their firm appearance. Over time, breasts become softer and saggier, as fatty tissue becomes more prominent and the skin covering the breast loses its elasticity.

Besides age, other factors that contribute to breast sagging include:

  • Pregnancy and breastfeeding
  • Weight changes
  • Gravity
  • Genetic makeup

Breast lift surgery can help restore the position of the breasts, which some women desire for aesthetic reasons. It can also decrease the size of the areolas if they have enlarged over time.

With firmer and uplifted breasts, you may:

  • Achieve a more youthful, better-proportioned breast profile
  • Fit more comfortably in bras and swimsuits
  • Improve your self-esteem (if this is related area of concern)

Breast lift surgery does not significantly change the size of your breasts. If you desire larger breasts, talk with your surgeon about combining a breast lift with a breast augmentation surgery. If you desire smaller breasts, you may be a candidate for breast lift and breast reduction surgery.

Patients who are potential candidates for breast lift surgery include those who have (and are bothered by) one or more of following:

  • Sagging breasts or breasts that have lost shape or volume
  • Breasts that are pendulous or have a flat or elongated shape
  • Nipples and areolas that point downward
  • Nipples that fall below the breast crease when not supported
  • Breasts that are positioned asymmetrically
  • Stretched breast skin and enlarged areolas
  • One breast that is lower than the other

During your consultation visit for a mastopexy, your surgeon will review your goals, candidacy, and the possible risks of the surgery. You will also undergo various breast measurements to assess factors like your degree of sagging, skin and tissue quality, areolar size, and presence of breast asymmetry.

If you decide to proceed with breast lift surgery and are deemed a good candidate by your surgeon, you will then need to be medically cleared.

This involves pre-operative testing, such as:

You may also be asked to have a mammogram if you are over the age of 40 or have a high risk of developing breast cancer.

How to Prepare

Prior to your breast lift surgery, your surgeon will give you instructions on how to prepare.

Location

Breast lift surgery is performed in a hospital or surgical center by a plastic surgeon.

What to Wear

Since you will change into a hospital gown upon arriving at the hospital or surgical center, it's best to wear clothes that are easy to remove on the day of your surgery.

Do not wear makeup, hairspray, cream, lotion, or perfume, nail polish, or artificial nails. Leave all jewelry (including body piercings) and valuables at home.

Food and Drink

If you are undergoing general anesthesia, you will be asked to avoid eating or drinking anything after midnight on the eve of your surgery.

Medications

You will be advised to stop taking certain medications, like non-steroidal anti-inflammatory drugs (NSAIDs), and certain vitamins/herbal products that may cause increased bleeding. If you have diabetes, you will be given instructions regarding if and when to stop your medications.

It's important to inform your surgical team of everything you take, including prescription and over-the-counter medications, herbal products, dietary supplements, vitamins, and recreational drugs.

What to Bring

On the day of your surgery, be sure to bring:

  • Your driver's license and insurance card
  • List of your medications
  • A shirt that can be buttoned or zipped in the front to go home in
  • Slip-on shoes to go home in (to avoid having to bend over)

If you are staying overnight in the hospital, you will need to pack a bag with the following items:

  • Toiletries (e.g., toothbrush and hairbrush)
  • Comfort items (e.g., earplugs, small pillow, or tablet)
  • Medical devices, if applicable (e.g., inhaler)

Whenever you are discharged, you will need to arrange for someone to drive you home. It will also likely be recommended that you have someone stay with you for at least the first night after surgery.

Pre-Op Lifestyle Changes

Your surgeon will ask you to stop smoking at least six weeks prior to surgery—this includes marijuana, hookah, and vaping.

You may also be advised to limit alcohol consumption to less than two to three drinks a week prior to surgery.

What to Expect on the Day of Surgery

On the day of your breast lift surgery, you will arrive at the hospital or surgical center and check-in. You may be asked to show your driver's license and insurance card.

Before the Surgery

After checking in, you will be taken to a surgical holding area. Here, you will change into a hospital gown and grip socks.

A nurse will review your medication list, record your vitals, and place an intravenous (IV) line into a vein in your arm. You may receive an antibiotic through the IV at this time to help prevent postoperative infection. This IV will be also used for administering fluids and other medications during and after surgery.

Your surgeon will then come to greet you and review the specifics of the operation. If you are undergoing general anesthesia, your anesthesiologist will also come to say hello and discuss medication administration. You may need to sign additional consent forms at this time.

Besides mentioning the potential risks of surgery and anesthesia, the required consent forms will review the possibility of unsatisfactory results after surgery (e.g., unanticipated breast asymmetry/shape/size and unattractive scar appearance).

From there, you will walk on your own into the operating room or be wheeled on a gurney.

During the Surgery

In the operating room, the anesthesiologist will give you inhaled or intravenous medications.

If you are undergoing general anesthesia, this will render you temporarily unconscious. Once you are asleep, a breathing (endotracheal) tube or a laryngeal mask connected to a ventilator will be inserted into your windpipe (trachea).

If you are undergoing local anesthesia, the area around your breast will be injected with a numbing medication. You will also likely be given a sedative to help you relax and sleep.

Your surgery will take around one to two hours to complete and will generally proceed with the following steps:

  • Incision: Depending on the technique used, the surgeon will use a scalpel to make one to three incisions in your breast.
  • Breast tissue reshaping: After the incisions are made, excess skin will be removed and the breast tissue will be lifted and reshaped to achieve a tighter, more defined breast profile. Sutures will be placed deep within the breast tissue to support the new breast position.
  • Nipple and areola repositioning: The nipple and areola will be moved to a higher position on each breast. Sometimes, the size of the areola will be made smaller by surgically cutting the skin around its perimeter.
  • Drain placement: In some instances, a thin tube will be temporarily placed underneath the skin near the incision site(s) to drain excess blood or fluid.
  • Closure: The incision(s) sites will be closed with sutures, skin adhesive, and/or surgical tape and covered with a gauze pad or other dressing. A surgical bra will then be placed.
  • Prep for recovery: Anesthesia will be stopped and the breathing tube will be taken out (if applicable). You will then be wheeled to a recovery area.

After the Surgery

In the recovery area, you will wake up from the anesthesia or IV sedation. At this time, you may feel drowsy and experience breast pain and nausea. Your nurse will administer medication to ease these symptoms.

Once you are awake and alert, and the staff deems you are ready, you will be discharged home. Alternatively, if you are staying overnight, you will be wheeled from the recovery area to a hospital room.

Recovery

Once you are home, expect to have breast soreness, bruising, and swelling. Itching around the incision sites and increased firmness or fullness in the breast tissue is also common. These symptoms generally persist for around two to four weeks.

To ease your breast discomfort, take your pain medication exactly as prescribed. To reduce swelling, you will need to sleep in a recliner or on your back for at least the first two days after surgery. This helps minimize any pressure on your breasts.

Your surgeon will also ask that you wear your surgical bra continuously for the first one to two weeks after surgery. This will be followed by wearing a support bra (that clips or zips in the front) at all times for at least four more weeks.

Keep in mind that numbness in your nipples and breasts after a mastopexy is also common. Sensation usually slowly returns over the weeks and months after surgery; although, in some instances, the numbness may last up to two years. Occasionally, the loss of sensation is permanent.

Wound Care

When caring for your incision sites, you will need to check them daily for signs of infection.

In terms of showering, double-check with your surgeon, but most patients can shower 24 to 48 hours after surgery. An exception to this may be if you have drains. In that case, your surgeon may ask that you not shower until 48 hours after the drains have been removed.

When you do shower, you will need to remove your surgical or support bra carefully, wash your incision sites gently with warm water, and pat the skin dry with a clean towel. After you shower, you will need to put your surgical/support bra back on.

Avoid bathing or submerging your incision sites in water until approximately two weeks after surgery (and when your surgeon gives you the go-ahead).

Activity

While you will be advised to rest after surgery, you will want to get out of bed for short periods of time starting the day after surgery. Over the next several days, you can then gradually increase your activity level.

That said, you will need help with household chores (e.g., cleaning and laundry) and caring for young children and pets for at least a week or two after surgery.

Your surgeon will also provide you with specific instructions regarding your activity after surgery, such as:

  • Limit over-the-head activities for the first one to two weeks after surgery.
  • Avoid driving for at least three weeks and until you are off all prescription pain medications.
  • Avoid lifting anything heavier than five pounds for four weeks.
  • Avoid sexual activity for a minimum of one to two weeks.
  • Avoid strenuous exercise for six weeks.
  • Avoid hot tubs or swimming for six weeks.
  • If you work, you can return around one to four weeks after surgery (depending on what your job requires).

Follow-Up

Expect to see your surgeon a few days after surgery, especially if you had drain(s) placed. At this appointment, your surgeon will remove any drains, check your incision sites, and monitor for complications.

Ten to 14 days after surgery, you will have non-absorbable sutures removed from your incision sites.

When to Call the Doctor

Call your doctor right away if you experience:

  • Fever or chills
  • Worsening or persistent swelling or bruising
  • Severe or worsening pain that is not relieved with medication
  • Swelling, redness, warmth, bleeding, or foul-smelling drainage from the incision site(s)
  • Reaction to any medication (e.g., rash, headache, nausea/vomiting, or constipation)
  • Calf pain, trouble breathing, or chest pain


Long-Term Care

The results of a mastopexy are seen immediately; although, the full results will be seen in three to six months. Incision sites will continue to heal and fade within a year.

While your post-surgical scars will improve over time, it's important to avoid exposing them to the sun for at least 12 months after surgery. This will help minimize their appearance as much as possible.

If avoiding sunlight is not possible, you should wear sunblock with an SPF of 30.

For additional scar reduction, your surgeon may recommend massaging petroleum jelly or a lubricating moisturizer over the scar twice daily for 10 minutes.

That said, be sure to talk to your surgeon before performing any scar massages. Massage needs to be performed carefully and only started once the wound has closed completely (around two to three weeks after surgery).

Possible Future Surgeries

While it isn't usually needed, a revision mastopexy could be needed for undesirable surgical outcomes, like scar appearance, or complications, like recurrent breast sagging.

In addition, sometimes a revision surgery is desired to touch-up a prior breast lift, as the overall lifespan of a mastopexy depends on factors like age, genetics, and weight fluctuations.

A Word From Verywell

Undergoing any surgery, including a breast lift, is a major decision and requires careful thought and research. If you are considering a breast lift, it's a good idea to seek out more than one opinion.

Also, be sure to talk to your plastic surgeon about their experience and credentials, and ask to see prior patients' before and after photos. Reviewing the potential risks of the surgery and what you can realistically expect as an outcome is also important.

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