A breast lift (mastopexy) is a surgical procedure focused on reshaping and elevating the breast mound. It does not require breast implants, which are used in the separate operation called breast augmentation. Mastopexy corrects breast ptosis (sagging), while augmentation adds volume and fullness. Combining them into a single operation, known as augmentation-mastopexy, is common for women who require both a lift and restoration of lost volume.
The Primary Goal of a Breast Lift
The purpose of a breast lift is to address the effects of gravity, aging, or changes like pregnancy or significant weight loss that cause the breasts to droop. The procedure corrects breast ptosis by surgically removing excess skin and tightening the surrounding soft tissues. This restores the breast to a more elevated position on the torso.
A primary action in mastopexy is the upward repositioning of the nipple-areola complex (NAC), which may have fallen below the inframammary fold. The surgeon also reduces the size of the areola if it has stretched due to skin laxity. Reshaping the existing glandular and fatty tissue gives the breast a firmer, more contoured appearance.
Various incision patterns, such as the lollipop or anchor shape, are used depending on the degree of sagging. The procedure focuses purely on height and shape correction. A standalone mastopexy enhances the contour and profile of the upper body without adding material.
When Implants Are Recommended
Implants are recommended when a breast lift alone cannot achieve the aesthetic goal, usually due to a significant lack of volume. This often occurs when breasts have experienced deflation or atrophy after pregnancy, breastfeeding, or substantial weight reduction, resulting in a flattened appearance, especially in the upper pole.
While a lift addresses breast position, it does not restore lost internal volume. Removing excess skin during mastopexy can sometimes slightly decrease overall size. Implants provide the necessary volume to fill the newly tightened skin envelope and create fullness, particularly at the top of the breast.
The decision to incorporate an implant is based on the surgeon’s assessment of the remaining native breast tissue and the patient’s desire for increased size. If the remaining tissue is insufficient for the desired projection, augmentation is introduced to achieve a balanced result. The implant acts as a permanent volume replacement, complementing the lift’s reshaping and elevation.
Considerations for a Combined Procedure
Performing augmentation-mastopexy simultaneously offers the benefit of a single surgical session and recovery period. This dual approach addresses both breast position and volume at once, which is often necessary for a complete transformation. However, combining the procedures increases the complexity and duration of the surgery.
The planning process is more intricate in a combined case. The surgeon must choose an implant size and placement that works in harmony with the new breast position. The implant must be correctly sized to avoid overstretching the newly tightened skin. An implant that is too large can compromise the long-term results of the lift by causing the breast to sag prematurely.
While single recovery is an advantage, the complexity means a more involved healing process compared to a lift or augmentation alone. Patients face a higher risk of complications, such as implant malposition or rippling, because both the breast tissue and the implant pocket are manipulated. In cases of severe ptosis or poor skin quality, a surgeon may recommend a two-stage approach, performing the lift first and the augmentation later, to ensure a predictable outcome.