Dr. Karen Horton has either authored or reviewed and approved this content.
Dr. Horton - I just wanted to thank you for seeing me the other day for my breast lift consult. Your approach in getting to know me so well and understanding my goals meant so much. I cannot wait to schedule my surgery!
„“Ptosis” of the breasts, also known as breast droop, and “deflation” of the breasts can occur after pregnancy, after significant weight loss or with age. A mastopexy reshapes the breast by rearranging the breast tissue, redraping loose breast skin, and lifting the nipples and areolas to a higher and more aesthetic position on the breast.
The goal of “mastopexy” (breast lift) is to create a perkier, lifted, more youthful breast shape. Your mastopexy result should look natural, like you were just born that way! Mastopexy surgery can help to improve a woman’s body image, and in many instances can help “lift” her self-esteem and self-confidence!
A breast lift rejuvenates sagging breasts to an elevated and more aesthetic position, but does not increase the overall breast volume. We perform an “auto-augmentation” technique where the upper pole of the breast is filled with breast tissue (in the same location that a breast implant is placed to increase upper pole fullness). On occasion, a breast implant will also be placed at the same time as mastopexy to achieve a fuller, enhanced breast with more upper pole fullness and projection (as if wearing a push-up bra) in addition to a breast lift alone.
Good candidates for mastopexy include women who are healthy, in good physical shape, and at their ideal body weight (or a stable weight following major weight loss).
Typical breast lift patients include women who have satisfactory volume but sagging breasts that lack substance or firmness (breast “deflation”), and/or with nipples and areolas pointing downward (breast “ptosis”). Many women with droopy breasts state they are “happy in a bra” and they just wish to have that effect with a breast lift.
Moms may find they miss the shape and fullness of their breasts from the time before they had children, or possibly the fullness of while they were nursing their babies. Other women are seeking better symmetry of their breasts if one is a significantly different size or shape than the other, or if their breasts have a “tubular shape”.
Drag the slider to see transformation
Drag the slider to see transformation
Drag the slider to see transformation
The droopy, saggy or “ptotic” breast has three main issues: (1) the breast tissue has lost its shape, it has deflated and hangs low on the chest with loss of upper pole volume, (2) the nipples and areolas droop on the breast, often pointing downward, and (3) there is an excess of empty breast skin.
Mastopexy therefore entails three separate but intimately related components: (1) reshaping the breast tissue and relocating it higher up on the chest wall, (2) repositioning the nipple to a more youthful position on the breast and reducing an enlarged areola diameter, and (3) removing and redraping extra breast skin.
Each breast lift technique creates an incision around the nipple and areola in a circular pattern. This allows the nipple to be repositioned on the breast and the areolar diameter to be reduced as necessary. Structures leading to the nipple including nerves, blood vessels and milk ducts are preserved in a breast lift. The various techniques of mastopexy may include additional incisions based on the shape of the breast, the degree of skin excess and nipple ptosis.
Each breast lift and reduction performed by Dr. Horton involves an “auto-augmentation”. This involves creating an upper pole pocket where normally a breast implant would be placed. This is where the nipple and areola are rotated up into, to create a more compact and shapely breast that sits higher up on the chest wall.
The most common procedure for a breast lift involves an incision around the nipple and areola, a vertical incision from the bottom of the areola down to the inframammary fold (IMF), and a short scar that lies within the IMF. These incisions are shorter than the traditional “anchor scar” that is commonly described. Our patients often refer to their IMF scar more as a “cat’s smile” than an anchor, as it should be hidden in the fold of the breast rather than extending to each side like an anchor.
The inverted T technique creates the most perky breast shape, and truly creates a three-dimensional reshaping of the breast. The nipple and areola are left attached to their blood vessels, nerve supply and ductal supply. By maintaining these vital connections, the return of nipple function (sensation and the ability to nurse) is promoted after surgery.
The inframammary scar is hidden when viewing the breasts from above or from the front, is concealed in bras and even triangle-top string bikinis, and is generally only visible on careful inspection up close when the breasts are lifted. The vertical incision generally fades to be nearly imperceptible, and the areolar scar lies at the natural junction of the pigmented areola and surrounding breast skin.
For breasts with a minimum of skin redundancy and only mild nipple droop, the “lollipop technique” can be used. This method creates the periareolar and vertical incisions only, without the horizontal IMF scar. The nipple blood supply, nerve supply and ductal supply is maintained, like in the inverted T technique. This technique is not appropriate for extremely droopy breasts or those with a significant amount of extra skin, where a true three-dimensional reduction of the breast envelope is required.
Occasionally, a very subtle lift of the nipple and areola is desirable for one or both breasts. The “periareolar” technique creates an incision in the area around the areola (the pigmented circle that surrounds the nipple), at its junction with the breast skin. This technique does not address excess skin or enable major reshaping to the breast. A small periareolar lift can be added to a breast augmentation when the nipple requires minor repositioning but major reshaping of the rest of the breast is not required. This is the technique most often used in tubular breast correction where there is minimal droop of the breast but there is an enlarged areola with a puffy shape that is to be corrected.
To restore breast volume after having children or after major weight loss, a breast implant can be placed at the same time as a breast lift. Occasionally, breast augmentation alone will help to lift the nipples very subtly. However, a combined mastopexy and augmentation procedure is indicated if there is significant ptosis of the breasts and the goal is to have the effect of a push-up and padded bra to enhance breast volume and projection. Please see our section on combined mastopexy-augmentation for more information about combined breast lift with implants.
Breast lift is a very frequent component of Mommy Makeover surgery! Please see our Mommy Makeover section to learn about changes that commonly occur in the breasts, the tummy and other areas of your body after pregnancy, and about mastopexy as a component of a Mommy Makeover!
All breast procedures should ideally preserve the two major functions of the breast: (1) breastfeeding and (2) erogenous sensation to the nipples. During a mastopexy, only skin (no breast tissue) is typically removed; the breast tissue is then rearranged with the goal of reshaping the breast but maintaining breast function. Vital anatomic structures of the breast (milk ducts, nerves and blood vessels) are preserved. The ability to breast feed is best promoted by using this method.
Unfortunately, some women may be unable to breast feed even without having breast surgery. Keep in mind that supplementation with formula may be required if you do not produce a large volume of breast milk in any situation.
After a mastopexy, sensation should slowly return to the nipple; however this can take from many months up to a year or more to fully recover. It is recommended that you wait at least six months after any breast surgery for your next mammogram, as your breasts may have some residual swelling or tenderness.
Please see our Preparing for Surgery section to learn about risks and potential complications related to surgery and Postoperative Instructions for Breast Surgery for additional information pertaining to breast lift.
Please see our Preparing for Surgery section to learn about what happens in the operating room on the day of surgery.
During a breast lift, an incision is made around the nipple and areola, and excess skin is removed. The remaining breast tissue is itself rearranged three-dimensionally to reshape the breast. The nipple and areola are relocated to a higher and more aesthetic location, while maintaining their connections to the rest of the breast. The remaining breast skin is then redraped to complete the procedure. Mastopexy generally takes 3-4 hours to complete.
Liposuction can be added to a mastopexy to help shape the outer region of the breast, providing the best contour, and to debulk the “axillary roll” (armpit fat) and back roll regions. Your surgeon will examine these areas to determine whether liposuction is an appropriate addition to your breast lift. Please see our Liposuction section for more information.
Please visit our photo gallery to see before and after mastopexy (breast lift) results!
The results of a breast lift are permanent, and your breasts will remain perky with their new shape and natural-looking for many years. However, your breasts will age with you over time, as appropriate. Your surgeon will follow up with you and ensure that your breasts still look fabulous for many years after your surgery. There is no reason to undergo any additional surgery unless you are experiencing a problem or unless you wish to do so.
At your initial mastopexy consultation, your surgeon will spend a great deal of time with you to get to know you personally and take a complete medical history. As women Plastic Surgeons, we intimately understand how a woman’s feelings about her breasts can influence her self-image and her femininity, and we aim to give you the result you are looking for! We will explore your reasons for seeking a breast lift, examine your breasts, and if you are an appropriate candidate for surgery, your options will be described in detail.
Dr. Karen Horton has either authored or reviewed and approved this content.
Give us a call or fill out form below to schedule online.
Dr. Karen M. Horton
2100 Webster St UNIT 520
San Francisco, CA 94115
Phone: 415.923.3067
We are located in the Pacific Heights District in the Pacific Professional Building.
Monday-Friday: 9am - 5pm
Saturday-Sunday: Closed
Monday:
9 AM to 5 PM
Tuesday:
9 AM to 5 PM
Wednesday:
9 AM to 5 PM
Thursday:
9 AM to 5 PM
Friday:
9 AM to 5 PM
Saturday:
Closed
Sunday:
Closed
Dr. Karen M. Horton
2100 Webster St UNIT 520
San Francisco, CA 94115
Phone: 415.923.3067
We are located in the
Pacific Heights District
in the Pacific Professional Building.
SHOP SKIN CARE*Please note: Our office is no longer a Participating Provider for insurance. We can provide a financial quote for what anticipated surgical fees will be after your consultation.
