Mastopexy
Mastopexy is essentially a tightening of the breast skin by excision. It can be highly variable in its extent. It may include relocation and/or reshaping of the nipple/areolar complex. It can be combined with breast augmentation, either with a mammary implant or less commonly with a patient’s own fat as a graft.
I perform mastopexy as an outpatient procedure in the hospital or in the accredited surgical center. It can be done under general anesthesia or more commonly by conscious sedation and local injection of anesthetic. Mastopexy can and should improve breast shape (especially superior fullness), provide symmetry with the opposite breast, and restore the nipple areolar complex to a normal position. Any of the various techniques for mastopexy require incisions on the breast, and thus subsequent scars. These scars can be limited in appearance, especially at the skin/areola junction. Women often express the hope that insertion of an implant alone will provide any needed lifting of the breast and nipple areolar complex. The truth is that if the breast is sagging considerably and the nipple areolar complex is below the middle of the breast, then mastopexy is probably necessary to achieve their goal. Although there is no guarantee of preservation of breast/nipple sensation and normal lactation ability, that is the usual result in my experience.
Mastopexy provides a permanent change to the breast shape, but over time all breasts are subject to age and gravity, moreso if an implant is present. An implant can be placed at a subsequent surgery after mastopexy, or it can be done at the same time. A combined procedure of mastopexy and implant augmentation introduces an additional risk of imperfection to the final result (even though the intra-operative result may seem ideal) which might require surgical revision. The vast majority of mastopexy patients, however, do not require surgical revision. During the consultation and examination, a careful review of the patient’s goals and breast problems are discussed, along with the various strategies and techniques for best achieving their goal. The goal of a more natural and youthful looking breast with minimal scars and no complications is the usual result.