Types of Breast Lifts

A breast lift, or mastopexy, surgically raises and creates firm breasts by restoring fullness, roundness, natural breast support and the youthful shape that many women want. There are different types of breast lift techniques such as Standard Lift, Donut Mastopexy and Lollipop Lift. The different types of breast lifts all have these items in common:

• The removal of breast surface skin
• Lifting of the breast gland
• Re-suspending it higher on the chest
• The rearrangement of the remaining skin and breast glandular tissue to accomplish the desired aesthetic goals

The main reason for a breast lift is sagging of the breast from weight loss or post-pregnancy changes. Women who feel their breasts sagging want to lift the breast gland higher on the chest or lift the nipples to a higher position on the breast mound or lift both the breast tissue and the nipple. By moving the breast gland and nipples upwards and tightening loose breast skin, a lift effect is produced. The nipple remains attached on the breast gland and does not move.  It’s actually the skin around the nipple and areola (pigmented skin around the nipple) that moves.

The scar extending downward from the areola brings the surrounding skin together and tightens the skin envelope while supporting the breast in a higher position and creating a more youthful, robust breast shape with nipple projection.  In essence, breast sagging results from a high ratio of skin surface to contained breast volume.  By removing skin surface, and tightening the remaining skin around the existing breast gland, the surface to volume ratio is diminished and creates a full, perky breast shape.

Am I a Good Candidate for a Breast Lift?

In general, GOOD CANDIDATES for the various types of breast lifts include:

• Healthy patients who are at a stable weight
• People with breasts that are flat and/or elongated
• Patients with chronic back pain from the weight of their large breasts
• Women with areolas and nipples that point downward
• Patients with one breast that is lower than the other
• Women with stretched skin and enlarged areolas

Patients who are NOT GOOD CANDIDATES include:

• Patients who are pregnant or plan on becoming pregnant as weight loss and gain can void the breast lift results
• People who smoke or are not in general good health

How are Different Types of Breast Lift Performed?

There are several breast lift techniques and they include:

• Standard Lift – The surgeon creates a series of anchor-shaped incisions on the patient. The first incision goes around the areola border and then a second vertical incision runs to the base of the breast. Finally, a third incision is made along the crease of the breast.  There will likely be some scarring but the standard lift does provide a perkier appearance. Many women are good candidates for this technique but it is best suited for women with smaller breasts.
• Donut Mastopexy – A technique that requires less skin removal than the anchor incision method so there is less scarring and a faster recovery. The doctor makes circumferential incisions around the areola and nipple to remove the required amount of tissue. This lift choice is not ideal for women with very saggy breasts because the small amount of skin removed limits the amount of lifting.
• Lollipop Lift – This lift technique is also known as a vertical mastopexy. The doctor makes an incision around the nipple and areola that runs down to the breast crease to create a moderate lift. It also has less scarring than a standard lift. Ideal candidates for this technique include women who want less scarring with a nice breast shape.  Some surgeons prefer this technique over the standard lift while others prefer the standard approach. 

Patients can have breast implants at the same time as a breast lift.  Implants add volume to the breast and fullness, especially to the upper breasts. Standard implant choices include round silicone, round saline and shaped “gummy bear” implants. Breast implants are available in many sizes, shapes, and textures including teardrop, round shaped, highly cohesive (more solid) and less cohesive (more liquid). Implants combined with a breast lift are often placed sub-muscular which means deep to the pectoral muscles.

What is the Cost of Breast Lift Procedures?

The cost of any type of breast lift depends on a number of factors including fees charged by the doctor, geographic location of the procedure, amount of work performed during the lift, whether or not implants are used, facility fees and anesthesia fees.

A standard breast lift costs around $7000-$13,000, while donut mastopexy is in the range of $4500-$10,000. A lollipop lift can cost anywhere from $5000-$15,000. The final price depends on the amount of tissue removed, the type of lift performed and if the lift is combined with other procedures.

Recovery and Downtime

Everyone is different and no one heals at exactly the same rate but there are some RECOVERY and DOWNTIME factors common to all breast lifts.

• After a breast lift, some swelling occurs. The patient should wear a supportive bra after a breast lift.  Supporting the breast in its lifted position for a few weeks after surgery promotes a better result with less complications and less scarring. Some surgeons add supportive tape across healing scars as an added measure of security during healing.
• Every patient is different when it comes to pain after the surgery. Some patients do not take any pain medication after surgery while others manage it with pain medication.
• No matter which type of breast lift is performed on a patient, the person should have help at home after surgery to allow rest and to facilitate the recovery process. Total time off work depends on the patient’s daily activity level and what is expected of them at work. In general, patients should not do heavy lifting or strenuous physical activity after surgery for 2-3 weeks. Patients who closely follow their instructions after surgery will get the best results possible with the least amount of scars.

Results

The various breast lift techniques are designed to provide long lasting, and even permanent, results. However, normal aging can alter the results of any breast lift because gravity and connective tissue changes influence the breasts over time. As women continue to age, they will likely see some descent of the breasts but never to where they were before the breast lift.

Pregnancy and weight gain can also affect the results of any breast lift. If there is weight gain or a pregnancy, the breast will change in size and get bigger. After pregnancy, breasts will get smaller again. Weight gain and loss, as well as pregnancy, can cause sagging breasts. If a patient has a breast lift before pregnancy, and then breastfeeds, there is always a possibility of sagging again. If this does happen, a surgeon can redo the same incision type and redo any type of breast lift that way.

Limitations and Risks

A big LIMITATION for any type of breast lift is the technology that can be used for the breast lift. For example, the sutures doctors use only hold their tensile strength for a certain amount of time. The doctor is relying on the body to cross-link collagen fast enough to hold the results as any internal sutures are absorbed. This is why patients need a good support bra as they are healing because the incision (where the scar will be) is located at the bottom of the breast. All of the weight settles at the bottom of the breast, and rests on the incision, so it can sometimes open up a little bit. Thankfully, the incision is a tiny opening that can be cleaned, bandaged and healed.

The other limitation with breast lifts is the type of lift that can be performed on a patient. The size of the breasts, as well as the amount of sagging, determines the type of breast lift performed on a person.

With any type of breast lift technique, there are RISKS:

• Asymmetry
• Scarring
• A small opening of the wound
• Patient dissatisfaction with the results
• Skin Necrosis (a rare risk)  

Consult with a Doctor before Making a Decision

Anyone interested in having a breast lift should consult with a board-certified plastic surgeon in order to determine which breast lift procedure will give the desired results.  Sometimes, several consultations are needed to gain a better understanding of the available choices and the results that are possible to achieve.

Written by Cosmetic Town Editorial Team - MA

Based on an exclusive interview with Steve Laverson, MD in Encinitas, CA