Please see the frequently asked questions about breast lifts to the right.
The General Information page also contains useful discussion for patients considering a breast lift or mastopexy.
There are many different types of mastopexy. Breast lifting can be considered for breast droopiness seen after breast feeding or significant weight loss. Some women are born with stretchy breast skin or tuberous breast and may have naturally occurring droopy breasts. After examining your breasts the most appropriate procedure recommended will be discussed with you in detail along with the rational for this choice.
There are 3 main techniques used when performing mastopexy
1. Vertical gland plication
2. Wise pattern skin tightening
3. Peri-areolar tightening
Vertical Mastopexy techniques
The vertical gland plication is the main technique that I use. This is a technique that evolved in France and across Europe and more recent modifications have been made in Canada. Some of the more famous surgeons names associated with vertical plication techniques are: Claude Lassus, Madeline Le Jour, Daniel Marchac and Elizabeth Hall-Findlay.
The advantages of the vertical technique is the breast gland tissue itself is modified in shape to produce a cone shape, the breast shape tends to hold itself more securely over time with less “bottoming out than skin tightening techniques and the inframammary crease scar can be minimized or not used at all.
The disadvantages are that the techniques is more complex and there is a learning curve, an inframammary crease scar is still required after massive weight loss cases, and a skin ripple can be left beneath the breast that in about 10-20% of cases may need to be removed under local anaesthetic 3 months later if it does not completely flatten. This is no additional charge for my patients when this is required.
Wise Pattern techniques
This technique is appropriate when performing mastopexy for massive weight loss patients who have very poor tissue recoil or for anyone who has a large amount of excess skin in the lower part of the breast.
The Wise pattern is a W-shaped pattern of skin incision that leaves a scar around the nipple and vertically down to the inframammary crease (like the vertical mastopexy) and also leaves a scar running along the inframammary crease. Essentially the skin is cut out and reshaped like a bra.
The advantage is that the initial result looks very good but the disadvantages are the increased likelihood of bottoming out with time and the long inframammary crease scar.
A periareolar mastopexy is performed using an incision around the areolar only. This can be a useful technique for minimal drooping. However it is not suitable for large amounts of skin redundancy as the breast tends to be flattened as the suture is tied around the areola, the skin will have more ripples and both the scar and the areolae can widen with time. The Bunelli technique is a common peri-areola technique and a number of modifications have been described with de-epithelialised dermal pedicles to decrease scar stretch.
Mesh mastopexy techniques
I have not used mesh techniques and I mention it for historical interest. This technique involves the use of synthetic or biologic meshes around the breast gland as a cone or as a sling beneath the breast (but under the skin). The Goes technique is one well-known mesh technique. Mesh techniques were devised to maintain breast shape however the mesh could become exposed or infected or suffer other foreign body related complications.
Complications of mastopexy
The main complications after mastopexy include
1. Shape change- ongoing over time
2. Unrealistic expectations
4. Sensation change
6. Volume changes
Breast Lift Gallery
Click here to view a gallery of breast lift (mastopexy) examples performed by Mr C Davis.