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Breast lift (Mastopexy) and Breast Lift / Implant (Mastoplexy Augmentation)

About the procedure

A mastopexy, or breast lift, is a plastic surgery procedure that is used to lift a patient’s breasts and give them a more youthful aesthetic appearance. As women age, their breasts naturally change shape. Younger women typically have a higher amount of breast glandular tissue than fat, which causes their breasts to be fuller and firmer. During pregnancy, the amount of glandular tissue increases even more and the breasts get larger. However, after pregnancy, the glandular tissue disappears and the breasts can appear deflated. Even without pregnancy, the breasts of older women tend to have more fat than glandular tissue, which also contributes to the deflated appearance that is common in older breasts. Due to the effects of gravity and skin stretch over time, the breasts also gradually sag, or become ptotic over time.

In order to correct the sagging appearance, a mastopexy (breast lift) is performed. During this procedure, Dr. Hirsch will mark the position of the new nipple and will then design the skin excision and breast tissue rearrangement based on the amount of nipple. The incisions that are used for this procedure vary depending on the degree of sagging (or breast ptosis). For breasts that have minimal droop, an incision around the nipple can be used. As the drooping increases, a vertical extension below the nipple with occasionally a horizontal incision at the bottom of the breast may be used as well.

Although the mastopexy procedure can correct a droopy, sagging breast, it usually does not add significant fullness to the breasts. For women who desire a breast lift but want to add volume, an augmentation mastopexy procedure is performed where the breast is lifted and a breast implant is inserted as well. This combined procedure adds volume and fullness, and corrects the droopy breast! Dr. Hirsch usually performs this procedure in one stage and as an outpatient procedure, so women can go home the same day as surgery.

Patients generally do not experience a significant amount of discomfort following a mastopexy or mastopexy augmentation. There may be some bruising around the breast and some tenderness as well, but in general patients will be able to resume normal daily activities by 1-2 weeks. During the first few weeks after surgery, Dr. Hirsch may ask you to wear a soft, supportive garment such as a sports bra while the incisions are healing.

Frequently asked questions about mastopexy:

What will my scars look like after a mastopexy?

There are several different possible scar appearances following mastopexy, depending on the type of mastopexy that is performed. In a circumareolar mastopexy, the scar is located around your areola and is minimally visible. This type of mastopexy is only used to correct minimal breast ptosis. In a circumvertical mastopexy, the scar is located around your areola and extends vertically down your breast. The circumvertical skin pattern is used to correct moderate amounts of breast ptosis. For larger amounts of skin ptosis, a Wise pattern mastopexy is used, which results in the anchor incision. This type of incision leaves a scar that goes around your areola, extends vertically down the breast, and the extends out to both sides in the inframammary fold under the breast. This may be performed with a limited scar under your breast, known as a short scar mastopexy, or with a more extensive scar under your breast for patients with a larger degree of breast ptosis.

What will happen to my nipple sensitivity after mastopexy?

It is difficult to predict how your nipple sensitivity will change after mastopexy surgery because there are many different variations of the procedure. If you have larger breasts that are more droopy (ptotic), you will need a more extensive surgery to lift them, which could result in more changes to the nipple sensation. If an implant is used, nipple sensation can be further affected. At the time of your consultation, Dr. Hirsch will discuss the possible changes to your nipple sensation.

Is mastopexy surgery covered by insurance?

Most major health insurance companies do not cover mastopexy surgery.

Will I be able to breast feed after mastopexy?

There is limited information in the literature about the ability of women to breastfeed following mastopexy surgery, partly because there are so many different types of mastopexy procedures that exist! Most women who want to breast feed after breast augmentation surgery are able to breastfeed, occasionally with formula supplementation.

When can I start exercising again after mastopexy surgery?

You should definitely start walking the night of your mastopexy surgery!  Generally you can move around normally and perform normal daily activities right away, but nothing strenuous or difficult until Dr. Hirsch gives you the ok - which takes 4-6 weeks after surgery.

When can I go back to work after mastopexy surgery?

Depending on what type of work you do, you might be able to go back to work within the first week after your mastopexy surgery.  If you work at a job that requires significant physical activity, you might need to be off work a bit longer.

Will I have drains after mastopexy?

In most cases, Dr. Hirsch does not use drains after mastopexy.

Meet Dr. Elliot Hirsch

Dr. Elliot M. Hirsch is a Board Certified Plastic and Reconstructive Surgeon who specializes in both cosmetic and reconstructive breast surgery. He is one of the busiest and most sought after plastic surgeons in the Los Angeles area, and has published over 40 papers in the breast surgery field. Dr. Hirsch has been educated at some of the most prestigious institutions in the country, including Johns Hopkins University, the University of Southern California, and Northwestern University.

To read more about Dr. Hirsch, please visit his extended biography page.
Read Dr. Hirsch's Biography