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Breast Lift

The Procedure

A breast lift is a surgical procedure that lifts the breasts to a higher and more youthful position. Due to many factors, including weight fluctuation, weight gain and weight loss, pregnancy or breastfeeding, patients can have displacement of the nipple areolar complex below the inframammary fold with increased skin laxity.  During rapid weight gain and then loss, patients will often have increased breast volume and then a decreased volume with skin laxity that becomes permanent.  As a result, the breast lift may be required.

A breast lift is a procedure that raises the nipple areolar complex reducing the amount of skin laxity and drag along the lower breast.  In an ideal breast lift, the breast itself could be lifted without external scars on the breast itself.  The degree of ptosis will determine the type of breast lift that will be performed. 

Ptosis Classifications

Grade
Description
Photo Example
Grade 1 Areola at the level of the mammary crease and above the contour of the gland Grade 1
Grade 2 Areola below the level of the mammary crease and above the contour of the gland Grade 2
Grade 3 Areola below the level of the mammary crease and below the contour of the gland Grade 3
Grade 4

Pseudoptosis in which the nipple areolar complex is either above or at the inframammary fold; however, there is redundant skin.

Grade 4

Methods of Surgery

Internal External
Associated with elevation of the nipple areolar complex. Most associated with scarring.
Tightening of the external skin envelope without external scars. Needed when there is significant breast tissue volume.
Often involves repositioning of the implant. Used when there is significant skin laxity (the nipple greater than 3 cm below the fold).
Smoothing out of external stretch marks. Used when implants alone will not tighten the breast enough to allow for repositioning.

Incision Types

Crescent
Lift

Removing skin along the areolar

Benelli
Lift

Known to be an unpredictable incision, may cause additional scarring.

Lollipop
Lift

Allows tightening of the breast and repositioning of the nipple areolar complex.

Anchor
(Wise-Pattern)

Useful for patients with severe ptosis, this is known as a formal mastopexy.

Anesthesia

Breast lifts should be performed under general anesthesia with a Board Certified Anesthesiologist. In general, breast lift procedures are not painful. There are fewer nerves in the breast tissue and therefore patients have significantly less pain with breast mastopexy than with breast augmentation.

All anesthesia is performed by Board Certified anesthesiologist, Dr. Hoffman.

Laryngeal mask airways can be used in the majority of the patients.  However, those who have a history of reflux or gastroesophageal disease are usually better candidates for endotracheal tube intubation.  This should be discussed with your Board Certified Anesthesiologist.

Cost

Breast lift cost will vary per patient.

This includes surgeon’s fee, operating room fees, implant cost and anesthesia fees.

Surgery Time Table

Preoperative Patient is started on an intervenous antibiotic (Ancef, Cipro and Vancomycin).
Surgery Full breast lift surgery takes approximately 90 minutes.
Recovery Room At least one hour. This is a requirement of federal law in Medicare.
After Surgery Patients are sent home with oral antibiotics to take for the first 7 days, as well as pain and nausea medications.
First Postoperative Visit All dressings placed by Dr. Linder are removed.
Day 7 Dressings are removed and should be replaced by the patient twice daily.
Day 14 Sutures are removed.
Day 21 The breasts are examined. Light activities may possibly be resumed.
Day 24 Patients started on scar treatment regimen. The Linder Bra should be worn at night
Day 28 Normal activities can be resumed. An underwire bra may be worn.

Frequently Asked Questions

» Who is an ideal candidate for a breast lift?

The ages can vary, depending upon the pathology and diagnosis that we find.  Women who have finished breastfeeding and lactating are often excellent candidates for formal mastopexies.  Those women often desire to have increased volume in the upper pole and upper medial breast and therefore an implant will be placed concurrently with a breast lift.  Women in their late 30s and early 40s are excellent candidates for mastopexy procedures.  I do however perform mastopexies in younger women that have congenital breast asymmetry where one breast is tight and smaller and the other breast contralaterally is larger and saggy with grade 3 ptosis.  In order to regain symmetry, a formal lift is often necessary on the larger ptotic breast.  

» What should I know prior to surgery?

Women should be healthy, should not be smokers, should be taken off estrogen products within 10 days of surgery to prevent DVTs and pulmonary embolus, they should be psychologically ready for this operation.  They should be well-informed and do their due diligence, understanding that the scarring is unpredictable and that it can include keloids, hypertrophic scarring, hypo/hyperpigmentation and widespread scarring.  

Planning of breast lifts requires a Board Certified Plastic and Reconstructive Surgeon who is trained in breast surgery, understanding the anatomy, especially when combining augmentation mammoplasty with a breast lift or mastopexy, devascularization of the nipple areolar complex could occur if there is not a significant blood supply due to widespread undermining of the tissue flaps.  

» What are the risks of scarring?

Breast lift procedures come with a significant tradeoff of scarring.  The scarring for breast lifts can be permanent and severe.  Even in the hands of the best plastic surgeons, scarring can include widespread scars, hypertrophic scars, keloid, hypopigmentation, and hyperpigmentation.  As a result, patients must be aware of the permanency of these scars and know that there is no guarantee to the final result.  The tradeoff of scarring for a tighter breast can be significant.  This should be a well throughout and informed decision made by the patient prior to undergoing the operation.  Scarring can never be completely predictable, including incisions that are as simple as a periareolar crescent lift.  Scarring may be improved however with treatments, including intralesional steroids, Bio-Corneum or Kelo-cote silicone gel spray, vitamin E cream or specific laser therapy, including YAG erbium lasers.  

» What should I look for when choosing a surgeon for a breast lift?

Your breast lift surgeon must be a Diplomate of the American Board of Plastic Surgery, may also be a member of the American Society of Plastic Surgeons, should be a fellow of the American College of Surgeons, should be well-trained in all aspects of plastic and reconstructive surgery.  

Dr. Linder specializes in breast augmentation, breast lifts, breast reductions, and breast revision surgery

» What are reasonable expectations for the surgery?

The expectations must include:  scarring is your tradeoff for lifting and tightening of the skin, also that rebound or recurrent skin laxity is very common and tightening of the breast may be required even less than one year after surgery.  Placing an implant and a lift at the same time will increase your need and necessity for skin retightening.