Higher… Mastopexy

Mastopexy, also known as breast lift, is a surgical procedure that consists in reducing ptosis (sagging of the breast caused by stretched skin). The surgery may be coupled with breast augmentation in cases where the ptosis is due to a massive loss of breast tissue. Mastopexy elevates the nipple and areola, providing the breast its former shape and firmness.

There are several methods of performing a mastopexy (see the various classifications of ptosis in Figure 1). The technique opted for depends on:

• Amount of breast and fat tissue
• Amount of skin to be removed
• Position of breasts in relation to chest and arms
• Symmetry in volume of breasts and size of areolas
• Choice and taste of patient

The type of incisions determine the amount of skin to be removed (Figure 2). Once the excess skin has been removed, it is detached from the mammary gland. The gland is then attached to the pectoral muscle with permanent sutures. The nipple and areola are then repositioned (Figure 3).

The example below (see Figures 2 and 3) is a demonstration of the anchor-shaped incision.

Depending on the technique used, the shape of the scar will be:

• An “anchor” (Figure 4)
• An “I” (no horizontal scar underneath breast fold (Figure 5)
• A periareolar incision (only around areola) (Figure 6)

Technique	Ptosis	Advantages	Disadvantages
Periareolar (around areola)	I ½	- Short scar	- Areolar asymmetry (around areola) - Skin folds - Round form and little projection
I Form	II	- Short scar around areola - Nicer areola shape - Absence of skin folds	- Oval shape - Vertical scar( > 5cm)
Anchor-shaped	II III-a III-b	- Nicer shape around the areola - Nicer areola scar - Absence of skin folds	- Vertical scar( > 5cm) - Horizontal scar (hypertrophic)

Usually, after one year the scars will hardly be visible. Mastoplexy is performed under general or local anaesthesia and the surgery lasts 2 to 3 hours

Convalescence takes 10 to 14 days.