A breast lift (mastopexy) raises the position of the nipple by removing excess skin and tightening the surrounding tissue to create a more youthful breast contour. Over time, factors such as pregnancy, breastfeeding, weight fluctuations, and the natural aging process can cause the breasts to lose their elasticity and volume, leading to ptosis (sagging). A breast lift (mastopexy) is a surgical procedure designed to lift and reshape sagging breasts.
Generally, there are multiple skin incision approaches for breast lifts: crescent mastopexy; circumareolar mastopexy (“donut”); vertical mastopexy (“lollipop”); and vertical mastopexy with horizontal extension (“anchor”).
Generally, a mastopexy involves making a small incision near the nipple.
In the least invasive type of mastopexy, a crescent-shaped piece of skin above the nipple is removed. This allows Dr. Desrosiers to lift the nipple to a higher position on the breast and then suture it in place. This procedure is usually indicated for people with only a minor amount of nipple asymmetry and/or ptosis (sagging of the breast).
Even though this surgery may not provide the maximum lift possible, some patients opt for it because it results in fewer scars. For certain patients, accepting less than perfect correction may be worth it for the benefit of reduced scarring.
The next step up from the crescent mastopexy is the circumareolar mastopexy. It follows a similar method, but instead of removing skin only above the nipple, skin is taken all around the nipple. This allows for a greater lift compared to the crescent mastopexy because more skin is removed.
Ellacor is a non-surgical procedure to tighten the skin. Dr. Desrosiers has used Ellacor on the upper portion of the breast to tighten the breast tissue and gain some lift with at least 3 sessions of Ellacor. This technique is designed to be scarless and approach the lift achievable with a crescent mastopexy. You can learn more about Ellacor here.
A vertical breast lift includes a scar around the nipple and down the middle of the breast. This is sometimes called a “lollipop” scar because of the resemblance to a lollipop. In some cases where even more lift is needed, a horizontal incision will also be placed in the inframammary fold underneath the breast. When the bottom portion is included, the scar is sometimes referred to as an “anchor” scar because of its resemblance to an anchor.
To help ensure the best scar outcome, Dr. Desrosiers employs a meticulous approach. First, understanding each patient’s unique response to sutures is important. During the consultation, Dr. Desrosiers and his staff will seek to understand your medical history, including any prior procedures and experiences with stitch abscesses or rejection, to tailor the surgical approach accordingly. Second, Dr. Desrosiers uses preoperative photos and marks the patient while standing, leaning, and lying down. He refers to these photos intraop and then uses a custom tailor tacking approach aimed at delivering precision. Third, Dr. Desrosiers may utilize slowly dissolving or permanent sutures beneath the skin to prevent scar widening until wound remodeling has transformed weak Type 3 collagen into more robust Type 1 collagen. Fourth, Dr. Desrosiers almost always requires the use of compression garments, not only to alleviate swelling but also to provide support to the tissues, minimizing tension on the scar line. Lastly, our practice offers cutting-edge treatments such as activated collagen gel, advanced silicone scar gel, and laser scar therapy, which have shown remarkable efficacy in promoting seamless scar formation for many patients.
Most patients are back to work in a few days. However, exercise/sweating generally needs to be avoided until the wounds fully close, commonly in 10-14 days. After that period, most patients can resume non-strenuous exercise. In most cases, all usual activities can be resumed in about 6 weeks. However, some patients may be required to wear surgical support bras for longer than 6 weeks to help minimize pressure on the incision sites.
Crescent or IMF mastopexies can be performed under local anesthesia. In the case of lollipop or anchor incision approaches, it is possible in some patients if no implants are used. Dr. Desrosiers typically performs all breast surgeries with implants in a sterile operating room. Even if a breast lift is performed under general anesthesia, these are outpatient procedures that do not require overnight hospitalization.
Rarely a complication can occur such as nipple/areolar necrosis, more often in patients with severe ptosis. The degree of ptosis is classified according to the position of the nipple relative to the natural breast fold. The longer the distance from the sternal notch to the nipple, the greater the increased risk of nipple loss.
Patients that have excessive ptosis are at a higher risk for partial (or complete) nipple loss. This is because moving the nipple over a long distance means the blood supply to the nipple may be compromised; this may require the nipple to be cut loose and grafted at the new site as a “free graft.”
In some cases where people have had severe ptosis and are at an elevated risk for nipple / areolar necrosis, we’ve used liquid amnion injections, hyperbaric oxygen therapy (HBOT), and/or the Oxyspur® Oxygen Diffusion Dressing. Note, in our experience, none of these are covered by insurance for this indication.
It is possible. However, it depends on the degree of lifting needed and the size of implant used. This is because making the breast smaller and then putting in an implant can increase the pressure on the suture sites. In some patients, this might increase risks of scarring or wound dehiscence. However, certain patients are willing to accept this risk because they need or desire to have the procedure done in one session. These aspects are addressed comprehensively during the consultation process to ensure a thorough understanding of your perspective and goals in addition to your medical and surgical history.
To help ensure the best scar outcome, Dr. Desrosiers employs a meticulous approach. First, understanding each patient’s unique response to sutures is important. During the consultation, Dr. Desrosiers and his staff will seek to understand your medical history, including any prior procedures and experiences with stitch abscesses or rejection, to tailor the surgical approach accordingly. Second, Dr. Desrosiers may utilize slowly dissolving or permanent sutures beneath the skin to prevent scar widening until wound remodeling has transformed weak Type 3 collagen into more robust Type 1 collagen. Third, Dr. Desrosiers almost always requires the use of post-operative surgical bras, not only to alleviate swelling but also to provide support to the tissues, minimizing tension on the scar line. Lastly, our practice offers advanced treatments such as activated collagen gel, advanced silicone scar gel, and laser scar therapy, the combination of which have shown remarkable efficacy in promoting seamless scar formation for many patients.
Dr. Desrosiers understands that each patient is unique and requires individualized care. With his expertise and dedication to achieving exceptional results, Dr. Desrosiers is committed to guiding you through your breast lift journey with confidence and support.
To learn more about breast lift or to schedule a consultation with Dr. Desrosiers, please contact us at 305-403-2922 or concierge@ArthurMD.com.
Providing Cosmetic, Reconstructive, & Craniofacial Plastic Surgery in Miami and West Palm Beach.