Breast Lift (Mastopexy)

All women’s breasts change over time. Aging, gravity, pregnancy, breastfeeding, weight fluctuations and other factors result in loss of youthful contour and firmness. Eventually, the breasts ‘sag.’ This is referred to as ptosis (pronounced ‘toe-sis’), and has multiple levels of severity. A breast lift, also known as a maxopexy, can help rejuvenate your figure with a more youthful, uplifted breast profile.

The combination of aging, pregnancy and breastfeeding, and gravity tend to accumulate more and more of the breast mass at the bottom of the breasts. This can create a pendulum-like appearance and can make you feel older than you should. Dr. Dawes seeks to bring the breast tissue back to a higher position on the chest. Lifts can downsize enlarged areolae and can also take nipples that may be pointing downward and bring them back to their natural higher position. And if a breast augmentation is also recommended and chosen, you will see an increased breast volume in all the right places for a fuller, more youthful look.

Is A Breast Lift Right for Me?

Not all women with ptosis require a breast lift. In milder cases, ptosis can be corrected with augmentation alone. During your initial consultation, Dr. Dawes will perform a thorough evaluation of your breasts, nipple position, and body shape. He will determine if you are a good candidate for a breast lift and make a recommendation tailored to your specific goals. He may also advise combining your breast lift with an augmentation should you want extra breast volume in addition to the lift.
A breast lift may be right for you if:

  • You are concerned that your breasts sag (have a flatter or elongated shape), or have lost volume
  • Your nipples point downwards or fall below your breast crease
  • You have stretched skin or enlarged areolas
  • One breast is noticeably lower than the other

Good candidates for breast lift surgery are individuals who:

  • Are healthy and maintain a stable weight
  • Are non-smokers
  • Have realistic expectations for breast lift improvement

How Breast Lift Surgery is Performed

This procedure raises, firms and re-contours the breast through removal of excess skin and tightening of the surrounding breast tissue. Excess breast skin is removed and the nipple and areola are shifted to a higher position. The areola diameter is often reduced at the same time as needed. The breast tissue is next lifted and internally supported by deep stitches. The skin is then closed with dissolvable stitches, tightening the breast. Dr. Dawes will use one of three possible incision patterns. During your consultation, the two of you will discuss your situation and your incision options to fit your personal needs. The incision options are as follows:

    • Areolar Incision
      Also called a peri-areolar mastopexy, a donut-shaped incision is made around the areola. This method creates minimal visible scarring but is only appropriate for women with minimal sagging who don’t need a lot of excess skin removed.
    • “Lollipop” Incision
      This incision circles the areola and then drops straight down, ending at the breast crease. This method allows moderate removal of excess skin and fat.
    • Anchor Incision
      This method circles the areola, drops down to the breast crease, and then extends outward in both directions, similar to the shape of an anchor. The anchor incision allows for the most skin removal and tissue adjustment to help achieve optimal breast shape.

Recovery Expectations

You can expect moderate discomfort of the breasts, which should gradually improve over 3-4 days. Swelling usually subsides after 3 weeks, but can occasionally persist longer. You may have bruising. It will be worst at 3-4 days post-op and may persist for up to 3-4 weeks. You will be advised not to raise your arms above your head for 3 weeks. Final results are long lasting, but will take a few months to appear as your breast shape and position continue to settle. Incision lines will be visible, but will fade over time. Maintaining a healthy weight and lifestyle will help maintain and prolong your results, though your breasts will still be affected by the natural aging process.

Breast Lift (Mastopexy) FAQs

What are the benefits to having a breast lift?
When appropriate, Dr. Dawes seeks to bring the breast tissue back to a higher position on the chest. Lifts are very satisfying procedures for women whose breasts have become pendulous. They can decrease the size of the enlarged areolae. They can also take nipples that may be pointing downward and bring them back to their natural higher position.
What should I expect at my breast lift consultation with Dr. Dawes?

Dr. Dawes views every consultation as a free-flowing give and take with the patient. He encourages any and all questions you may have about the procedure, its risks, and recovery.

You’ll begin by describing what you dislike about your sagging breasts and how you’d like to see them change. This is important so Dr. Dawes can learn the specific areas you’d like to address, plus it gives him the chance to be sure your expectations are realistic. He will then examine your breasts. At this point he will describe the incision options, including which he thinks is the best approach for your unique situation. He’ll describe how the surgery works, followed by what you can expect during recovery. He’ll go over the risks involved. When your consultation is finished, whether you decide to move forward with surgery or not, the goal is for you to be an expert in what is involved with a breast lift.

How long does a breast lift procedure take?
Dr. Dawes performs breast lifts as outpatient procedures with the patient under general anesthesia. Depending on the incision type and the amount of excess skin that needs to be removed, the procedure usually takes approximately 2-3 hours.
Will my breast lift results be permanent?
There’s no stopping the downward pull of gravity and the weakening of support tissues that is a part of normal aging, so your breasts will sag some more as you age. But they will start from a much higher, younger position after your breast lift. The degree of future sagging and flattening will be much less than would occur without having had a breast lift.
Will a breast lift increase the size of my breasts?
Breast lift surgery will lift what tissue you have, but it will not significantly change the size of your breast, or re-establish a rounded contour in the upper part of your breasts. Women with significant ptosis who also want more volume may consider a mastopexy-augmentation, which combines a breast lift with a breast augmentation. Women with significant ptosis wanting smaller breasts may consider a breast reduction.
What kind of pain will I experience post procedure?
Patients may experience some pain along the breasts and chest wall that usually settles within a few days. Dr. Dawes will prescribe you a pain reliever.
When will I be able to return to regular activity?
During the first 2 weeks after the surgery, you should avoid any strenuous activities. A supportive bra should also be worn during this time. For the first 6 weeks, sleeping on the stomach or sides should also be avoided.
What kind of swelling can I expect?
Following the surgery, you will have some mild bruising and swelling of the breasts. Most bruising will resolve in two weeks but swelling can persist for several months. The scars will also mature and fade with time and are generally hidden by wearing a bra.
What kind of bra should I wear post procedure?
Your post-surgical bra will be put on you prior to your leaving the surgical centre. You must wear the post-surgical support bra day and night for 3 weeks.  After 3 weeks you can then begin to wear a sports bra, then at 6 weeks you can begin with an underwire bra if you wish.
What will my scarring be like after a breast lift?
Scarring will be a part of these procedures, as the incisions are somewhat lengthy. But you’ll be surprised at how they fade with time and how well they can look hidden. Topical scar-minimizing post-op treatments keep the area moisturized and help to minimize the appearance of the scars. ScarHeal makes one such product called Scar Gel (for the face) and Scar Cream (for the body). Our Pre-orperative Nurse will go over your post-op care instructions with you in detail.
Will breast and nipple sensitivity be affected by a breast lift?
Breast lifts involve a good deal of repositioning of breast tissue, and this can affect nipple sensation in the short term. The nipples can be either numb or very sensitive. This is because the surgery usually disturbs some of the nerve pathways. But regular sensation returns in all but a very small percentage of patients. Still, since the areolae are usually repositioned in a breast lift, there is the possibility that some loss of sensation or sensitivity could occur. Overall breast sensitivity should not be affected. As with the nipples, there may be some temporary loss of sensation, but these issues should resolve as you heal.
If I think I may have more children should I still have a breast lift?
Dr. Dawes advises his potential breast lift patients to be pretty confident they do not want any additional children moving forward. This is because the changes he makes with your breast lift can be negated, at least to some extent, by the breast size gain and weight gain of pregnancy and breastfeeding. This can create new sagging afterwards. There is roughly a 40% chance that breastfeeding may be partially or completely hindered after a breast lift.
What are the risks of breast lift surgery?

Breast lifts are major surgery, so they include risks involved with surgery: bleeding or the formation of a hematoma, reaction to anesthesia, infection, and slow incision healing. Risks related to breast lifts include:

  • Changes in nipple or breast sensation (these usually revolve within a few months)
  • Irregularities in breast contour or shape
  • Breast asymmetry
  • Necrosis of fat tissue on the nipple areolar complex itself (rare)
  • Fluid accumulation
  • Possibility of the need for revision surgery

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“My role, in part, is to assist patients through the process of determining which surgical or non-surgical options would help them meet their aesthetic goals and realistic expectations”

Jeffrey C. Dawes MD, FRSC

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