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Breast lift

Mastopexy; Breast lift with reduction; Breast lift with augmentation

 

A breast lift, or mastopexy, is cosmetic breast surgery to lift the breasts. The surgery may also involve changing the position of the areola and nipple.

Description

 

Cosmetic breast surgery can be done at an outpatient surgery clinic or in a hospital.

You will likely receive general anesthesia. This is medicine that keeps you asleep and pain-free. Or, you may receive medicine to help you relax and local anesthesia to numb the area around the breasts to block pain. You will be awake but unable to feel pain.

The surgeon will make 1 to 3 surgical cuts (incision) in your breast. Extra skin, and sometimes some breast tissue, will be removed and your nipple and areola may be moved.

Sometimes, women have breast augmentation (enlargement with implants) when they have a breast lift.

 

Why the Procedure Is Performed

 

Cosmetic breast surgery is surgery you choose to have. You do not need it for medical reasons.

Women usually have breast lifts to lift sagging, loose breasts. Pregnancy, breastfeeding, and normal aging may cause a woman to have stretched skin and smaller breasts.

You should probably wait to have a breast lift if you are:

  • Planning to lose weight
  • Pregnant or still nursing a child
  • Planning to have more children

Talk with a plastic surgeon if you are considering cosmetic breast surgery. Discuss how you expect to look and feel better. Keep in mind that the desired result is improvement, not perfection.

 

Risks

 

Risks of anesthesia and surgery in general are:

  • Reactions to medicines
  • Breathing problems
  • Bleeding, blood clots, or infection

Risks of breast surgery are:

  • Inability to nurse a baby after surgery
  • Large scars that take a long time to heal
  • Loss of sensation around the nipples
  • One breast that is larger or shaped slightly differently than the other (asymmetry of the breasts)
  • Uneven position of the nipples

The emotional risks of surgery may include feeling that both breasts do not look perfectly balanced or they may not look like what you expected.

 

Before the Procedure

 

Ask your surgeon if you need a screening mammogram based on your age and risk of having breast cancer. This should be done long enough before surgery so if more imaging or a biopsy is needed, your planned surgery date won't be delayed.

Tell your surgeon or nurse:

  • If you are or could be pregnant
  • What medicines you are taking, even medicines, supplements, or herbs you bought without a prescription

The week or two before surgery:

  • You may be asked to stop taking blood thinning medicines. These include aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin, Jantoven), and others.
  • Ask your surgeon which drugs you should still take on the day of surgery.
  • If you smoke, try to stop. Smoking increases the risk for problems such as slow healing. Ask your health care provider for help quitting.

On the day of surgery:

  • Follow instructions about when to stop eating and drinking.
  • Take the drugs your surgeon told you to take with a small sip of water.
  • Wear or bring loose clothing that buttons or zips in front.
  • Arrive at the hospital on time.

 

After the Procedure

 

You will probably go home the day of surgery.

A gauze dressing (bandage) will be wrapped around your breasts and chest. Or, you will wear a surgical bra. Wear the surgical bra or a soft supportive bra for as long as your surgeon tells you to. This will likely be for several weeks.

Drainage tubes may be attached to your breasts. These will be removed in the office within a few days.

Your pain should decrease in a few weeks. Ask your surgeon if you can take acetaminophen (Tylenol) or ibuprofen (Advil) to help with pain instead of a narcotic medicine. If you do use a narcotic medicine, be sure to take it with food and plenty of water. Do not apply ice or heat to your breasts unless your doctor has told you that is OK.

Ask your surgeon when it is OK to shower or bathe.

Follow any other self-care instructions you are given.

Schedule a follow-up visit with your surgeon. At that time, you will be checked for how you are healing. Sutures (stitches) will be removed if needed.

You may need to wear a special supportive bra for a few months.

 

Outlook (Prognosis)

 

You are likely to have a very good outcome from breast surgery. You may feel better about your appearance and yourself.

Scars are permanent and are often very visible for up to a year after surgery. After a year, they may fade but will not become invisible. Your surgeon will try to place the cuts so that scars are hidden from view. Surgical cuts are usually made on the underside of the breast and around the edge of the areola. Your scars will generally not be noticeable, even in low-cut clothing.

Normal aging, pregnancy, and changes in your weight may all cause your breasts to sag again.

 

 

References

American Board of Cosmetic Surgery website. Breast augmentation guide. www.americanboardcosmeticsurgery.org/procedure-learning-center/breast/breast-augmentation-guide/. Accessed April 5, 2023.

Calobrace MB. Breast augmentation. In: Nahabedian MY, Neligan PC, eds. Plastic Surgery: Volume 5: Breast. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 4.

Padilla PL, Khoo KH, Ho T, Cole EL, Sirvent RZ, Phillips LG. Plastic Surgery. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 69.

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                Review Date: 3/11/2023

                Reviewed By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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