Gravity happens!  Breasts change with age and certainly after childbearing.  Restoring the shape and position of the breast can give you the confidence to wear that dress or bikini.

Mastopexy (Breast Lift)

A breast lift or a mastopexy is one of the more common procedures done to restore the breast to its natural position on the chest.  This operation is helpful for women of all ages and it can be performed in conjunction with other operations such as a breast augmentation and an abdominoplasty if desired.  

With time and gravity, the breast can often sag or get longer.  Having children or breastfeeding can also add to the change in shape and position of the breast. 

The internal ligaments in the breast called "Cooper's ligaments" stretch out over time and result in a lower breast than when a woman is younger. Cooper's ligaments are the internal support of the breast and help suspend the breast giving it a "perky" appearance.  The good news is this is a solvable problem.   

A mastopexy or breast lift raises the position of the nipple and the areola back to the level that makes the breast perky again. This level is typically mid-upper-arm level. A youthful breast has fullness at the top of the breast and the nipple is at or above the level of the inframammary fold.  

The excess skin and tissue from the breast are removed at the same time and make the skin over the breast tighter.  The incisions are the traditional "anchor" incisions, all the way around the nipple and then vertically and horizontally.  These incisions fade with time but will not completely disappear.  The incisions typically do not show in bathing suits or other clothing.  

There are other options for a mastopexy including a periareolar or vertical scar mastopexy.

These are good options for many patients, but the amount of skin that will need to be removed may make the traditional incision the best option for many women. 

The periareolar mastopexy is an incision completely around the nipple and the nipple areolar complex can be raised 1-2cm. Additionally, this allows to shape the central area of the breast if there is excess protrusion of breast tissue behind the nipple. The areola becomes more round with this operation and any asymmetries between nipple height can be corrected in this manner.   

The vertical scar mastopexy has an incision around the nipple areolar complex as well as a vertical scar below the areola. There is no horizontal scar along the base of the breast with this operation. Some excess breast tissue and skin can be removed from the lower portion of the breast allowing it to be tighter during the lift. This technique is limited with the amount of skin that can be removed. 

All of these options can be discussed when you meet with Dr. Cash to discuss your breast lift. The ultimate goal is for the breast to appear natural and return it to the normal position and look more youthful.   

Recovery from this operation is typically about 4 weeks, but most women feel well enough to do normal activity within a week. The operation is outpatient and the patient goes home the same day. 

The patient will have a post-operative bra that will be worn for 1 week.   A sports bra will be worn for a period of time following the operation.  Underwire bras are not encouraged as they can rub on the incision.  

The recovery period is mainly based on scar formation.  The scars will turn from red to pink to white over the period of eight to twelve months.  Keeping the scar out of the sun will improve the ultimate appearance of the scar and allow it to become as inconspicuous as possible.  Scar creams or silicone sheeting may improve the appearance of the scars as well. 

A surgical bra is worn for the first week and then transitioned to a sports bra. The patient is able to shower 48 hours after the operation. There are NO DRAINS! Drains have not been shown to be beneficial in this operation and typically are a hassle for the patient.   

All sutures are under the skin and no sutures will need to be removed.   

Returning to exercise after this operation is a gradual process. As the breast heals, adequate support is critical and any high intensity or high impact exercise must be limited for approximately 8-12 weeks following the operation. This is due to the stress that can be placed on the internal and skin sutures. 

During this healing period, limiting anything that may place tension on the lower portion of the breast will give you the greatest long-term outcome for a breast lift.  Although nothing can prevent gravity, adequate care during the recovery period can improve the results such that the benefit of this operation can be long-lasting.  

Additionally, a breast implant can be added to this operation if desired.  This would be called breast augmentation and mastopexy.  

A small breast implant positioned correctly will increase the fullness at the top of the breast. A smaller breast implant will give a full but natural look.  A breast implant of less than 200cc can provide what is referred to as upper pole fullness meaning that the top of the breast is full and corrects a ski slope appearance of the breast.  

The implant is placed through the existing incisions used for the mastopexy or breast lift and no additional scars are created.  Please refer to the breast augmentation page HERE for further information about breast implants and whether this would be a good option for you.  This is not always necessary and many women are very pleased with the outcome with no breast implant.  

Other things to consider when having a breast lift are the side effects that may accompany the operation. As with any operation, there are risks involved, but there are relatively few in a mastopexy.  These risks will be discussed in more detail during your consultation with Dr. Cash.  

There is a small chance that the nipple becomes numb on one or both sides. The greater the distance the nipple needs to be moved or the larger amount of breast tissue removed will increase this chance. 

If the patient wishes to breastfeed in the future, this may not be possible because when the nipple is raised to a higher position, some of the ducts must be divided. The breast will still produce milk, but it will just not be able to come out of the nipple.  This is not dangerous and just gives the sensation that the breast is engorged.  This will resolve with wrapping of the chest.  

The ultimate goal of this operation is to help the patient feel confident, improve the way clothes fit, improve breast symmetry, and restore the breast to its natural shape and position.  This operation can have benefits for years to come!  After the operation, women commonly say they wish they had done this years ago!  

Please contact us to learn more about how Nashville Plastic Surgery can help you!

Before & After Photos