Incision PATTERN

Periareolar – This breast lift involves making incisions completely around the areola, at the junction of the lighter breast skin with the darker, pigmented skin of the areola.  This approach works best for patients with good skin quality, little skin excess, and desiring correction of mild breast sagging, nipple malposition, or areolar reduction.

Vertical – This breast lift involves a “lollipop” incision, one that runs circumferentially around the nipple with an extension to the chest wall along the bottom of the breast.  This approach works best for patients with good skin quality, a small amount of skin excess, a need for a moderate amount of breast lift, and an areolar reduction.

Wise-Pattern – This breast lift creates an “anchor” shape incision, one that runs circumferentially around the nipple, with an extension to the chest wall along the bottom of the breast, and horizontally along the breast crease.  Though causing the longest scar of the three, Wise pattern breast lifts are the most powerful, allowing for the greatest amount of breast lift and skin removal.  This approach also allows for an areolar reduction.

Breast Implants

Women who have lost breast volume from pregnancy, breast-feeding, weight fluctuations, or aging, can combine a breast augmentation with a breast lift, correcting both issues with one surgery.  Termed an augmentation-mastopexy, this procedure restores the lost volume through use of an implant, while using one of the mastopexy approaches to lift the original breast tissue and reposition the nipple.

Soft Tissue Scaffold Support

Patients who have extensive laxity of their tissues, have heavy breasts, or desire a large augmentation-mastopexy, can benefit from the addition of a soft tissue support.  Acting as a sling, or hammock, this soft tissue support is incorporated by the body, and can help delay the recurrence of breast sagging by cradling the breast and/or implant, and removing the weight from the breast skin.

After the mastopexy approach has been chosen, the incisions are created, and the patient’s breast tissue identified.  In the periareolar mastopexy, a segment of extra skin is removed from above the areola, and the breast tissue then elevated and nipple repositioned in its place.  In the vertical or Wise-pattern mastopexy, the breast tissue is first reshaped to improve its contour and firmness, before the nipple and areola are elevated, and excess skin is removed.  The incisions are then closed in multiple layers, sterile gauze applied, and a wrap placed around the chest for comfort.

If an implant is being placed, the same mastopexy incisions are created, but before the breast lift is performed, a pocket underneath the chest muscle is created.  The implant is placed into this pocket, and the remaining procedure is performed as a stand-alone mastopexy.  The addition of an implant may convert a patient from needing the anchor incision of a Wise-pattern mastopexy, to the lollipop incision of a vertical mastopexy.

After surgery, patients return home to recover.  The surgery will cause swelling of the breasts, and pain that typically requires prescription medication for the first few days.  The surgical wrap is removed on the follow-up appointment, and patients are placed into a non-underwire bra until all of the incisions are healed.

Most patients need a few days, to a week, off from work to allow for a comfortable healing period.  The swelling will resolve over the next several weeks.  It will take several months for the breast to settle, the implants to drop, and the incisions to have begun to fade.

We believe in being preemptive to avoid common risks associated with surgery, but occasionally the following may occur:

Bleeding/Hematoma – A small amount of bleeding is common after surgery, but if severe enough, another operation may be required to stop it.  Bleeding can also form a collection, termed a hematoma, which presents as a swollen, painful, and enlarged breast.  These require drainage to prevent secondary problems.

Seroma – A fluid collection may form within the breast, or around an implant, and may require drainage.

Infection – A breast lift carries a small risk of infection, but if one occurs, it may require oral, or intravenous, antibiotics.  In the rarest of cases, if an implant is infected, it would need to be removed.

Poor Cosmesis: This includes asymmetries between the right and left breasts, and poor incision healing.

Fat Necrosis:  When operating on the breast, there is the possibility that a part of the tissue loses its blood supply.  This can lead to a localized area of hardness within the breast.

Nipple Sensation: A change in nipple sensation, either increased or decrease sensitivity, is not uncommon following surgery.  Usually temporary, sensation typically returns to normal within a few weeks.  In rare instances, this altered sensation may be permanent.

Nipple Loss:  As all mastopexies involve circumferential incisions around the areola, there is a small chance that the nipple and areola lose their blood supply and die.

Bra Size – Bra and cup sizes are useful for initial discussions on breast implant sizing, but because of the variety of bra manufacturers, each of which use their own sizing, there is no guarantee on a particular bra, or cup, size after surgery.

Long Term Changes: Much like non-augmented breasts, pregnancy, weight loss, gravity, and menopause will affect the appearance of your breasts and implants.  These changes may require surgery to restore a more youthful contour.

Are my breast lift results permanent?

Though a breast lift dramatically improves a breast’s shape and contour, it does not result in a permanent solution.  Factors such as gravity, and fluctuations in weight, that initially caused the sagging, will ultimately lead to a recurrence.  Future revisions may be needed to maintain your desired breast appearance.

What determines the extent and location of my scars?

The type of breast lift procedure needed is dependent on the amount of breast skin excess, in relation to breast volume.  The greater the skin excess, and the less volume in the breast, the longer the scar needed to obtain the best results.

What happens to my nipple and areola during surgery?

In order to match the more youthful contours of the breast, an areolar reduction is performed to balance the areola with the breast’s new size and shape.