Is Mastopexy a Major Surgery?

The breast lift, also known as mastopexy, is a procedure designed to lift and shape sagging breasts. 

Breast sagging occurs with aging, hormonal changes, weight loss and breastfeeding. The breast lift, also known as mastopexy, is a procedure designed to lift and shape sagging breasts.  

More than 100,000 mastopexies were performed in the United States in 2018, according to a report published by the American Society of Plastic Surgeons.

Generally, mastopexy is less painful than other cosmetic breast procedures and requires minimal follow-up care.

Sagging of the female breast is medically referred to as ptosis of the breast. Cosmetic surgeons classify sagging breasts according to the grades listed below. This helps guide potential mastopexy options: 

• Grade 1: In mild ptosis, the nipple lies just below the natural boundary of the breast (inframammary fold) but still above the lower portion of the breasts
• Grade 2: With moderate ptosis, the nipple goes further below the inframammary fold but with some lower portion of breasts present below the nipple
• Grade 3: With severe ptosis, nipple goes well below the inframammary fold, and no lower portion mass present
• Pseudoptosis: The sagging of the lower portion of the breast with the nipple at or above the inframammary fold.

• If you are planning for pregnancy, you should not undergo this surgery because breastfeeding might alter the breast structure
• If you had recurrent breast cancer, mastopexy might hinder detection or treatment of cancer
• If you are obese or have diabetes
• If you are addicted to smoking
• If you have contracted implants after breast augmentation

• If you fulfill all the criteria mentioned above, and if you wish to proceed with the surgery, discuss your goals and expectations with the surgeon.
• You will have to detail your medical and medication history and any related history.
• You may undergo a mammogram before the surgery if you are 35 or older.
• Your surgeon will discuss with you the possible risks and benefits of the procedure.
• Your surgeon will discuss the postoperative scars and changes in the sensation of the nipples.
• Your surgeon will ask for photographs that might help the surgeon to detect any asymmetries before the commencement of surgery.

• Mastopexy can be performed in an outpatient setting based upon your surgeon’s choice.
• Your surgeon might give local or general anesthesia to make you numb or unconscious throughout the procedure. 
• You will lie flat on the operating table with arms extended. 
• Depending on the type of surgery, an incision is made, which can be  
  • an egg-shape around the nipple, 
  • a vertical incision, or a 
  • keyhole-shape. 
• The nipple is detached and fixed at a higher site with a suture that keeps it intact.

• Wound care is minimal; you will be asked to wear a surgical bra for a few days
• Opioid pain medications may control postoperative pain
• You should limit your activities for up to six weeks
• Within two to three weeks, your stitches will be removed
• Generally, mastopexy is less painful than other cosmetic breast procedures and requires minimal follow-up care
• If you experience any of these side effects, immediately contact the physician:
  • Bleeding
  • Infection
  • Scarring
  • Asymmetry of nipples
  • Sensation changes of nipples
  • Fluid built-up at the site of incision

Advancement in mastopexy techniques will continue to improve recovery times and complications rates.