It is very unusual for a woman of any age to have perfectly equal-sized, full, and uplifted breasts. Most women request breast-lifting to be able to wear a strapless dress or go braless altogether and feel like their breasts have a truly firm and youthful shape. Sagging, asymmetry, and nipple-areolar deformities are the primary reasons to surgically reshape the breast. Mastopexy has many variations, some some of which only require minimal incision patterns. You can speak with Dr. Ptak during your consultation to figure out which is the best procedure for you specifically. Dr. Jeffrey Ptak feels that it is appropriate for a mature woman of any age to be given the chance to reshape her breasts in order to enhance her appearance, self-confidence, and self-esteem.

What is Mastopexy?

Mastopexy, or more commonly known as a breast lift, is a cosmetic solution of raising, reshaping, and contouring the breast in order to create a firm and perky bust. It does not change the actual size of your breasts, but rather lift them back to a more youthful shape. The American Society of Plastic Surgeons has found that Breast Lift procedures have increased 70% since 2000, surpassing Breast Augmentation with a 2-1 ratio. Mastopexy involves the removal of excess tissue and skin in order to tighten and improve the shape of the breast. During this procedure, the nipple will be repositioned to an appropriate spot on the newly raised breast. Mastopexy can be performed as a procedure on its own, or be paired with a Breast Augmentation or Reduction, depending on your goal and what Dr. Ptak feels is the best solution for you.

Who is a Candidate?

The best candidates for Mastopexy are women with small, sagging breasts with a significantly lowered nipple-areola. This can be due to past pregnancies, genetics, or aging and the sagging is too great to be treated with implant alone. Those with enlarged nipple-areolar complexes (pigmented areas around nipples) can reduce the size with a Donut Lift procedure. In some cases, women have a significant difference in the elevation of their breasts where one breast is lower than the other. This can easily be fixed with a Breast Lift procedure. Patients who have experienced considerable weight loss may also find a Breast Lift to be an excellent solution, removing excess skin and lifting the breast to a more youthful, contoured shape. There are 4 grades to ptosis, or sagging:

• Grade 1 - Mild ptosis: The areola sits at the level of the inframammary fold (bottom crease of the breast) but most tissue is still below.
• Grade 2 - Moderate ptosis: The areola is lower than the inframammary fold but some tissue is still below.
• Grade 3 - Advanced ptosis: The areola is lower than the inframammary fold and no tissue hangs below.
• Grade 4 - Severe ptosis: The areola is drastically lower than the inframammary fold and points south.

If you categorize yourself in any of these levels of ptosis, a Breast Lift may be the best solution for you.

Types of Breast Lifts

Crescent Lift

A Crescent Lift is designed for patients who only have minor sagging to correct. For this procedure, Dr. Ptak will make an incision on the top half of the areola in order to lift the breast. This small incision makes for minimal scarring. A Crescent Lift is typically performed when a patient is also having a Breast Augmentation procedure.

Donut Lift

Otherwise known as a Periareolar Lift, the Donut Lift is ideal for women who are experiencing minor sagging, but also want to make the circumference of their areola smaller. This procedure is performed by making a full circular incision tracing the areola. A Donut Lift can be performed along with Breast Augmentation as well, or as a procedure on its own.

Lollipop Lift

Also referred to as a Vertical Lift, a Lollipop Lift involves 2 separate incisions. Dr. Ptak will make one incision that runs around the circumference of the areola, while the other will be made from the base of the breast leading up to the bottom of the areola incision, much like the shape of a lollipop. This procedure is good for women who require more that just a minor lift. Through this process, excess skin will be removed, allowing Dr. Ptak to reshape the breast into a more perky, uplifted shape. With this procedure, minimal scarring will occur. But with consistent attention and care the scarring can fade overtime.

Anchor Lift

This procedure is designed for patients who have extensive sagging. Like a Donut Lift, this procedure will involve one incision around the areola and one running from the bottom of the areola to the base of the breast. But in addition, a third incision is made running along the inframammary fold (bottom crease) of the breast. Dr. Ptak will then remove the necessary amount of extra skin and tissue for your specific case. This procedure may also be paired with a Breast Reduction. An Anchor Lift achieves the biggest transformation for those who desire a dramatic change in the appearance of their bust. Some scarring will occur and will subside in time, but can also be covered with ease in a bikini top!

Alternative Procedures

Breast Reduction

Breast Reduction may be deemed appropriate by Dr. Ptak as an alternative procedure in order to achieve the best result for you. With Breast Reduction, the breasts will naturally become lifted due to the excess skin and tissue being removed. Your breasts will look smaller and more youthful.

Breast Auto Augmentation

Breast Auto Augmentation might prove to be a better solution for some patients. With this process, the breast is enlarged by soft tissue as opposed to an implant. And like Mastopexy, excess skin will also be trimmed, giving the breast a more lifted and firmer-looking contour.

Breform Internal Bra

If you are looking for an alternative to a standard Mastopexy or Augmentation with silicone or saline, this may be the option for you. This procedure surgically implants a permanent internal mesh-like bra to create an instant and long-lasting lift, so long as your weight stays relatively constant. The bra is made from polyester which is a non-biodegradable material. The mesh fuses with your tissue, however you cannot feel the internal bra, and it does not harden. It will not interfere with breast examinations. To determine whether Breform Internal Bra is a good alternative for you will depend on the size of your breast, skin quality, sagging, and the shape you desire. This procedure is great for Mastopexy, but can also be used for Breast Reduction or Breast Reconstruction after a Mastectomy procedure. Pregnancy does not affect lactation, and there is no disfiguration of the areola.

Botox Lift

Botox is a non-surgical solution for women who desire a small yet noticeable lift. Botox is injected into the chest muscle, but the back muscles are what provide the lift, similar the adjusting your posture. This is a temporary solution and is typically needed every several months for continuous lasting results. This process does not reduce or enlarge the size of your breast, and is recommended more for those who have minor sagging. Botox Lift works best for women with smaller breasts, no larger than a small C cup. There is no cutting involved with this, in turn leaving no scarring. This also means the effects are not as drastic as a surgical Breast Lift. Downtime for this Botox procedure is minimal to none.

Consultation

Preparation

At your consultation, you will be told to follow certain instructions prior to your surgery in order to give you the best results possible. This may include:

• Completing certain tests or evaluations.
• Stop smoking well in advance of your surgery.
• Take specific medications prescribed by Dr. Ptak, and possibly modifying or eliminating your current medications.
• Refrain from taking anti-inflammatory drugs and herbal supplements.
• Arrange your post-surgery transportation. You are not permitted to drive yourself home. Furthermore it is highly recommended you have a friend or family member stay overnight with you for at least the first night.

Procedure Information

Mastopexy usually takes one and a half to three hours. The procedure is done on an outpatient basis under general sedation and local or general anesthesia. The incision outlines the area from which breast skin will be removed and defines the new location for the nipple.

When the excess skin has been removed, the nipple and areola are moved to the higher position. The skin surrounding the areola is then brought down and together to reshape the breast.

Stitches are usually located around the areola, in a vertical line extending downwards from the nipple area and along the lower crease of the breast, depending on the lift. Some patients,

especially those with relatively small breasts and minimal sagging, may be candidates for modified procedures requiring less extensive incisions. If you are having an implant inserted along with your breast lift, it will be placed in a pocket directly under the breast tissue, or deeper, under the muscle of the chest wall. You will be able to see immediate results after the surgery is completed.

Postoperative Healing

Many patients are able to return home the day of surgery. The amount of care will depend on the extent of procedures you require. You will go home in a bra with only light dressings over the incision lines. The bra is worn as a “dressing” for 2 - 3 weeks. Sutures are usually buried and completely dissolvable; no suture removal is necessary. Initial discomfort is easily controlled with oral medication. Light activities may be started in 7-10 days.

Cost

The cost of Mastopexy depends on the extent of procedures you will specifically require. This can be discussed during your consultation with Dr. Jeffrey Ptak.