What is Breast Lifting?

What is breast lift? This term defines the technique of making the breasts tighter and lifting them up, primarily to improve a condition called breast ptosis, or downward relaxation. It is possible to have loss of breast tissue as a cause for ptosis, but it is also possible for the breast skin to stretch with pregnancy or weight gain, maintaining the same volume and still having the end result as breast ptosis. When the breast has lost its natural breast shape and when the nipple is below the level of the breast inframammary crease, this usually is defined as ptosis.

I have seen this condition caused by various reasons, the most common of which is atrophy of the breast tissue itself and stretching of the skin after pregnancy (and particularly after breastfeeding). In this case, the loss of volume may need to be replaced with an augmentation mammaplasty with implants, while the skin itself needs to be tightened to improve the contour of the breast which is contained by the skin. Other reasons for this can include severe weight loss with atrophy of the breast tissue, previous stretching of the breast due to enlargement, and finally too little volume and too much skin. There are variations of this which one must keep in mind when undergoing treatment. An example would be loss of breast tissue without any stretching of the skin. This can occur in long-distance women runners, whose bodies are subjected to changing hormone levels with excessive physical exercise and which helps the breast tissue to simply shrink away. Adding volume in this circumstance enhances the shape, brings the skin back to normal, and gives the nipple its correct placement. With postpartum breast atrophy and stretching of the skin, the skin must be tightened and an implant put in place for improving the shape. In this variation, the nipple must be moved up to the proper placement height in order to get a good result.

After a patient has breast implants, breast ptosis does not usually develop. This is because breast implants tend to hold the tissue from the inside by scar tissue around the implant. This prevents the breast from falling down into the ptotic position. However, in some cases minor stretching of the skin can occur and a minor mastopexy may then be utilized to tighten the breast.

How is correction of breast ptosis performed? 

If an implant is needed, then the implant is put in first. After that, the patient is placed in the sitting-up position so that the appropriate skin removal and tightening can be judged so that a good result can be achieved. This is done by pinching the skin underneath and deciding just how much could be removed. Additionally, the skin is freed up from the superior breast tissue so that the nipple can slide up into position. Skin that is below the nipple can be removed and thereby improve the shape, appearance, and tightness of the breast.

What are expectations in regards to results from this procedure?

The usual expectation in about 90% of patients is that the shape of the breast is improved, the fullness and tightness of the skin is improved, and the nipple position is usually good. However, in about 10% there may be mild or severe widening of the scars or even breakdown of the wound. A history of healing should be obtained from the patient before proceeding with this operative procedure, as difficult problems with the scars may occur with a small group of patients. Usually, patients are very happy with the results. It is helpful for them to be counseled carefully on expectations and possible complications. In general, this is a good operation, and careful planning combined with a careful history will help prevent some of the potential bad results that can occur from complications.