Breast lift

A breast lift (mastopexy) is surgery to reshape sagging breast tissue and move the nipple upward. The breasts may naturally sit low or may have sagged after weight changes, pregnancy, and breastfeeding. We determine the scope of surgery according to your existing breast volume, degree of sagging, and desired shape.

If the upper part of your breasts has also flattened, we can begin by discussing whether you would like to keep your current size or add fullness. We explain lift-only and lift-with-implant options according to your wishes and tissue structure.

Breast sagging and nipple position

When assessing the degree of sagging, we look at where the nipple sits relative to the fold beneath the breast. A nipple below this fold is one finding that helps establish the need for a lift. If mild sagging accompanies a lack of volume, augmentation alone with a silicone implant, a medical device placed to add volume, may also be an option.

The inframammary fold is the natural crease where the lower boundary of the breast meets the chest wall. The relationship between the nipple and this fold is a separate feature from breast size. A lift may therefore also be considered for a breast with little volume.

In mild sagging, the nipple approaches or sits at the level of the fold beneath the breast. In moderate sagging, it lies below the fold but above the breast’s lowest point. In advanced sagging, the nipple descends to the breast’s lowest level and may point downward.

In apparent sagging, or pseudoptosis, the nipple remains above the fold while the lower breast tissue extends below it. Upper breast volume loss may accompany this appearance. Examining nipple height and tissue distribution separately helps distinguish the need to add volume from the need to reshape tissue.

Skin, volume, and breast measurements at the examination

Breast size and shape indicate how much the internal tissue can be reshaped. Skin elasticity and excess skin indicate how the envelope around that tissue needs to be adjusted. Measuring the position of the nipple and areola, the colored area around the nipple, clarifies the relationship between the tissue to be moved and the skin adjustment.

The breast base is the area the tissue occupies on the chest wall. The distance from the nipple to the fold beneath the breast indicates lower breast length, while the distance from the chest midline indicates its position toward the inside or outside. These measurements are recorded separately for the right and left breasts. The plan therefore considers the length of the tissue to be reshaped in the lower breast as well as nipple height.

There may be enough breast tissue within an expanded skin envelope. In this situation, the existing tissue is gathered and reshaped. If tissue volume has also decreased, adding an implant may be considered according to the desired fullness.

A previous breast surgery report may explain which tissue connections were preserved when the nipple was moved. The locations of existing incisions and the scope of the previous procedure are considered alongside this information in the new lift plan. If an implant is present, its dimensions and placement layer are also examined in relation to the tissue to be reshaped.

Alongside measurements of breast shape, previous imaging and any biopsy results also inform the examination. A biopsy is the removal of a tissue sample for examination. A family history of breast disease or a change noticed in the breast is considered when selecting the necessary investigations.

Reshaping breast tissue

During a breast lift, we reshape sagging tissues, remove the portions that need to be taken out, and reposition the remaining tissue upward. We also move the nipple while preserving its connection to the breast tissue. The amount of tissue removed can vary depending on whether you want to keep or reduce your existing volume.

Excess skin is also removed during a lift, and the remaining skin is adapted to the reshaped breast tissue. The amount and elasticity of excess skin affect the scope of reshaping. Breast tissue volume and the condition of its skin covering are considered separately in the surgical plan.

The nipple and surrounding areola are moved to their new position on the reshaped breast. If the areola has a wide diameter, the surrounding skin adjustment may include this area as well. Nipple position is selected to suit the breast base and the newly arranged tissue distribution.

In a lift plan, shaping the internal tissue and adjusting the outer skin envelope are separate steps. Breast tissue gathered in the lower portion is reshaped, and the skin is adapted over it. The direction of skin removal affects the incision pattern, while the path along which the nipple will be moved affects the internal tissue arrangement.

Incision patterns for a breast lift

Incision around the nipple

An incision around the nipple follows the outer border of the areola. It may be considered when excess skin is limited and only a small adjustment to nipple position is needed. When there is extensive excess skin, removal confined to this circular area may not provide the required reshaping.

Vertical incision

A vertical incision pattern adds an incision running from below the areola toward the fold beneath the breast to the line around the areola. This provides space to remove excess skin from the lower breast and reshape the tissue. Lower breast length and the direction in which the skin is excessive are considered when choosing this plan.

Inverted T incision

An inverted T pattern adds a horizontal line along the fold beneath the breast to the incisions around the areola and down the breast. This option is considered when excess skin needs adjustment in both vertical and horizontal directions. The extent of the portion along the fold relates to breast base width and the skin to be removed.

Breasts with similar nipple heights may differ in skin elasticity, base width, and existing volume. When selecting an incision, these measurements are assessed in relation to the excess skin. At the examination, you can ask where the incision lines would lie on your breasts and which adjustment each would address.

Breast lift with implants

When pronounced upper breast fullness is desired, we can support the tissue with a silicone implant. We call this procedure augmentation with a breast lift. The lift reshapes the existing tissue, while the implant adds breast volume.

In a lift-only plan, we use the breast’s own tissue. If your desired fullness exceeds what the existing tissue can provide, we explain how augmentation could be included. If you would also like to reduce breast weight, we can discuss reduction.

In a lift with implants, volume relates to breast base width and the thickness of the tissue that will cover the implant. The skin envelope to be adjusted during the lift also informs this choice. The pocket to be prepared for the implant and the tissue connections supporting the nipple are described within the same surgical plan.

For someone who does not want implants, the lift plan is based on the volume of the breast’s own tissue and the areas to which it can be redistributed. The amount of tissue concentrated in the lower breast and the desired upper breast fullness are described separately. This allows the scope of reshaping with existing tissue to be explained before deciding whether to add an implant.

Differences between the breasts

Differences in size or shape between the breasts are called breast asymmetry. Many people have slight differences, while pronounced size differences can make choosing bras and clothing difficult. Options include reducing the larger breast or performing lifting and augmentation of different scope on each side. We explain which option is suitable based on your existing breast volume and desired size.

If both breasts lack volume, we can add augmentation to the lift. Depending on the difference in volume, an implant that provides more fullness may be chosen for one side.

Asymmetry may involve breast volume, nipple height, or the position of the fold beneath the breast. Chest wall shape also contributes to how the right and left breasts sit. The amount of skin to be removed and, if implants are used, their dimensions are selected separately according to the anatomy on each side.

Nipple height and the direction the nipple faces are different features. The right and left nipples may be at the same height while one points toward the outside of the chest. The positions of the breast bases may accompany this difference in direction. A lift plan therefore describes both the breast’s position on the chest wall and the nipple’s position on its own breast tissue.

When a reduction in volume is also desired during a lift, the amounts of skin and breast tissue to be removed are determined separately. Skin adjustment around the areola addresses the diameter of the colored area, while adjustment in the lower breast addresses breast length. Reducing tissue on the larger side and reshaping the other side while keeping its existing volume may be different parts of the same plan.

Areola width is examined as a feature independent of breast volume. A small breast may have a wide areola. In that case, adjusting the skin around the colored area is explained separately from the option of adding volume.

Candidacy and anesthesia planning

A cosmetic breast lift is not planned during pregnancy or breastfeeding. Completed breast development and general health suitable for surgery are also requirements for candidacy. If a medical condition is not under control, the relevant medical assessments need to be completed first. Because breast volume can change with weight, plans to lose weight are also discussed in relation to the skin and volume plan.

A breast lift is performed under general anesthesia in a hospital operating room. The anesthesia consultation includes the scope of planned breast tissue reshaping alongside medical history and current medications. Adding an implant, reducing volume on one side, or having had a previous breast operation all form part of this plan.

Breastfeeding and nipple sensation

Breastfeeding involves the connection between the milk glands, milk ducts, and nipple. A lift plan considers how the tissue carrying the nipple relates to these structures. You can share your pregnancy and breastfeeding plans at the consultation. The nipple’s connection to the milk glands, the planned tissue adjustment, and breastfeeding expectations can each be explained during this discussion.

Nipple sensation relates to nerve branches coming from the chest wall. These anatomical pathways are also considered when planning the tissue connections that carry the nipple. Breastfeeding and sensation involve different anatomical structures. Existing sensation and previous breast operations are therefore recorded separately at the examination.