Mastopexy/Breast Lift

Dr. Sian (Fresno Plastic Surgery) has been performing breast lift surgery/mastopexy in Fresno & Clovis since 2002.

Breast lift, or mastopexy is a surgical procedure to raise and reshape sagging breasts. Factors such as pregnancy, nursing, weight change, aging and gravity produce changes in the appearance of a woman’s breasts. As the skin loses its elasticity, the breasts often lose their shape and begin to sag. This operation can also reduce the size of the areola (i.e. the darker skin around the nipple). If your breasts are small or have lost volume after pregnancy, breast implants inserted in conjunction with mastopexy can improve both firmness and size of the breasts.

The best candidates for mastopexy or breast lift surgery are healthy women with realistic expectations of what this procedure can accomplish. Breasts of any size can be lifted, but the results may not last as long in women with heavy, large breasts. There are a variety of different surgical techniques used for the reshaping and lifting of the female breast. The type of scar associated with this procedure depends on the surgical technique that is used which is customized to each individual patient.

This procedure is usually done under general anesthesia on an outpatient basis and surgery time is approximately 2 hours. Recovery time is approximately 3 weeks.

It is recommended that the patient wear a support bra for at least 4 to 6 weeks after the procedure. Patients should avoid bras with underwire or push-up bras.

Questions covered on this page:

  1. Am I a good candidate for breast lift surgery?
  2. How will Dr. Sian evaluate me for breast lift surgery?
  3. Will my insurance help cover the cost of surgery?
  4. Where are the incisions placed?
  5. What are some variations to the common breast lifting technique?
  6. I understand that every surgical procedure has risks, but how will I learn more so that I can make an informed decision?
  7. How should I prepare for surgery?
  8. What will the day of surgery be like?
  9. How will I look and feel initially?
  10. When can I resume my normal activities?
  11. How long will the results last?
  12. Maintaining a Relationship with Your Plastic Surgeon

Am I a good candidate for a breast lift?

You may be a good candidate for breast lift surgery if you have one or more of the following conditions:

  • breasts that are saggy and pendulous, but of satisfactory size
  • breasts that lack substance or firmness
  • nipples and areolas that point downward, especially if they are positioned below the breast crease

Sometimes these conditions may be inherited traits. In certain cases, the breasts may have developed differently so that one breast is firm and well positioned while the other is not. There may be differences in the size of your breasts as well as their shape. Breasts that are large and heavy can be lifted, but the results may not be as long-lasting as when the procedure is done on smaller breasts.

A breast lift can be performed at any age, but Dr. Sian usually recommends waiting until breast development has stopped (at least 18 years of age). Pregnancy and breast-feeding may have significant and unpredictable effects on the size and shape of your breasts. Nevertheless, many women decide to undergo breast lift surgery before having children and feel that they can address any subsequent changes later. Since most of the milk ducts and nipples are left intact, breast lift surgery usually will not affect your ability to breast-feed; however, you should discuss this with Dr. Sian.

How will my plastic surgeon evaluate me for breast lift surgery?

During the consultation, you will be asked about your desired breast shape and size. Dr. Sian will discuss with you how your nipples and areolas will be repositioned. You should mention anything else about your breasts that you would like to see improved. This will help Dr. Sian understand your expectations and determine whether they realistically can be achieved.

Dr. Sian will examine your breasts and take measurements & photographs for your medical record. The size and shape of your breasts, the quality of your skin, and the placement of the nipples and areolas will be carefully evaluated.

You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries including breast biopsies, and medications that you currently take. It is important for you to provide complete information.

You should tell Dr. Sian if you plan to lose a significant amount of weight, particularly if you have noticed that your breasts sag or become smaller with weight loss. Dr. Sian may recommend that you stabilize your weight before having surgery.

Will my insurance help cover the cost of surgery?

Breast lift surgery is an aesthetic (cosmetic) procedure and is NOT covered by insurance.

Under certain circumstances, however, insurance coverage may be available. For example, if a breast reconstruction after mastectomy is performed, the opposite breast may need to be modified for symmetry. Many factors determine your eligibility for coverage, including the specific terms of your insurance policy. A letter of preauthorization may be required by your insurance company prior to surgery. Dr. Sian or his staff will discuss these matters with you.

Where are the incisions placed?

A common method of lifting the breasts involves three incisions. One incision is made around the areola. Another runs vertically from the bottom edge of the areola to the crease underneath the breast. The third incision is horizontal beneath the breast and follows the natural curve of the breast crease.

Dr. Sian’s preferred procedure is the vertical mammoplasty/mastopexy technique which utilizes a lollipop shaped incision that avoids the creation of the horizontal scar beneath the breast.

After Dr. Sian has removed excess breast skin, the nipple and areola are shifted to a higher position. The areola, which in a sagging breast may have been stretched, can be reduced in size. Skin that was formerly located above the areola is brought down and together beneath it to reshape the breast.

The nipples and areolas remain attached to underlying mounds of tissue, and this usually allows for the preservation of sensation and the ability to breast-feed.

Individual factors and personal preferences will determine the specific technique selected to lift your breasts.

What are some variations to the common breast lifting technique?

There are many variations to the design of the incisions for breast lift surgery. The size and shape of your breasts, size of your areolas, and extent of sagging are factors that will help Dr. Sian determine the best technique for you.

In some instances, it may be possible to avoid the horizontal incision beneath the breast. Sometimes a technique may be used that avoids this horizontal incision as well as the vertical incision that runs from the bottom edge of the areola to the breast crease.

If you are a good candidate for a modified technique, Dr. Sian will discuss this with you.

If you and Dr. Sian have decided that it is desirable to enlarge your breasts at the same time as they are lifted, this will require insertion of breast implants. If this is an option that you wish to consider, Dr. Sian will review the necessary information with you and may provide you with a brochure on breast augmentation.

I understand that every surgical procedure has risks, but how will I learn more so that I can make an informed decision?

Fortunately, significant complications from breast lifts are infrequent. Every year, many thousands of women undergo successful breast lift surgery, experience no major problems and are pleased with the results. Anyone considering surgery, however, should be aware of both the benefits and risks.

The subject of risks and potential complications of surgery is best discussed on a personal basis between you and Dr. Sian, or with his staff.

Some of the potential complications that may be discussed with you include bleeding, infection and reactions to anesthesia. Following a breast lift, sometimes the breasts may not be perfectly symmetrical or the nipple height may vary slightly. Minor adjustments often can be made at a later time. Permanent loss of sensation in the nipples or areas of breast skin may occur rarely. Revisionary surgery may sometimes be helpful in certain instances where incisions may have healed poorly.

You can help to lessen certain risks by following the advice and instructions of Dr. Sian both before and after surgery.

How should I prepare for surgery?

The goal of Dr. Sian and his entire staff is to make your surgical experience as easy and comfortable for you as possible.

Depending on your age, or if you have a history of breast cancer in your family, Dr. Sian may recommend a baseline mammogram before surgery and another mammographic examination some months after surgery. This will help to detect any future changes in your breast tissue. Following a breast lift, you will still be able to perform breast self-examination. Breast lift surgery will not increase your risk of developing breast cancer.

If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin, anti-inflammatory drugs (Ibuprofen, Alleve, Advil, Motrin, Mobic etc), and blood thinners (Coumadin, Warfarin, Plavix, Eliquis, Xarelto, Pradaxa etc.) can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. Other food supplements can also cause bleeding such as Gingko biloba, garlic, ginger, Omega 3 fatty acids, fish oil, ginseng, Vitamins C & E, Glucosamine, Chondroitin, Saw Palmetto etc.. Discuss the pros and cons of discontinuing these medications with Dr. Sian. Dr. Sian will provide you with additional preoperative instructions.

Breast lift surgery is usually performed by Dr. Sian on an outpatient basis. Be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night.

What will the day of surgery be like?

Your breast lift surgery is performed at the hospital by Dr. Sian.

Medications are administered for your comfort during the surgical procedure. Often, a general anesthetic is administered, so that you will be asleep throughout the procedure.

When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Sometimes, small drain tubes will have been placed in your breasts to help avoid the accumulation of fluids. Gauze or other dressings may be placed on your breasts and covered with a surgical bra.

You may be permitted to go home after a few hours, unless you and your plastic surgeon have determined that you will stay in the hospital or surgical facility overnight.

It is recommended that the patient wear a support bra for at least 4 to 6 weeks after the procedure. Patients should avoid bras with underwire or push-up bras.

How will I look and feel initially?

The day after surgery, you will be encouraged to get out of bed for short periods of time. After several days, you should be able to move about more comfortably. Straining, bending and lifting must be avoided, however, since these activities might cause increased swelling or even bleeding. You may be instructed to sleep on your back to avoid pressure on your breasts.

Any surgical drains will be removed a few days after surgery, as long as there is minimal amount of fluid being collected in the drain reservoir. Make sure you bring the drain record sheet to your appointment so that Dr. Sian is made aware of how much is being collected from the drains. This will help him decide if the drains can be removed.

Dr. Sian recommends that all the surgical dressings be removed or changed after two days. You can take a shower 48-72 hours after surgery as long as the incisions are intact, dry and healing well. Tub baths and/or swimming are not recommended. After taking your shower, dry your surgical incisions thoroughly with a clean towel, place a clean, dry gauze over the incision and wear your surgical bra to hold the gauze in place. Dr. Sian discourages the use of any tape on the breast as these can cause “tape burns”.

You will be instructed to wear a support bra for a few weeks, until the swelling and discoloration of your breasts diminishes. Most of the sutures used by Dr. Sian are buried absorbable sutures so no sutures need to be removed after surgery.

You may notice that you feel less sensation over the nipple and areola areas. This usually is temporary. It may, however, take weeks, months or even more than a year before the sensation returns. Permanent loss of sensation over parts of or the entire nipple and areolar complex is possible in some patients. Your breasts may also require some time to assume a more natural shape. Incisions will initially be red or pink in color. They will remain this way for many months following surgery and gradually lighten in color thereafter.

When can I resume my normal activities?

After breast lift surgery, it is often possible to return to work within 2-3 weeks, depending on your job. In many instances, you can resume most of your normal activities, including some form of mild exercise, after several weeks. You may continue to experience some mild, periodic discomfort during this time, but such feelings are normal. Severe pain should be reported to your doctor.

Any sexual activity should be avoided for a minimum of two weeks. Dr. Sian may advise you to wait even longer. Care must be taken to be extremely gentle with your breasts for at least six weeks.

How long will the results last?

Breast lift surgery will make your breasts firmer and more uplifted. The nipple and areola will be repositioned to make the breasts appear more youthful. The size of your areola will be altered as needed to complement the breast.

The incisions from your breast lift surgery will heal and fade over time. It is important to realize, however, that the incision lines will be permanently visible. In some instances, they will eventually be only faint lines. Certain individuals may have incision lines that are more noticeable. Fortunately, the incisions for your breast lift are in locations easily concealed by clothing, even low-cut necklines.

Unless you gain or lose a significant amount of weight or become pregnant, your new breast shape should remain fairly constant. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman’s breasts. After several years, if you become dissatisfied again with the appearance of your breasts, you may choose to undergo a second breast lift procedure to restore their more youthful contour and appearance.

Maintaining a Relationship with Your Plastic Surgeon

You will return to Dr. Sian’s office for follow-up care at prescribed intervals, at which time your progress will be evaluated. Once the immediate postoperative follow-up is complete, Dr. Sian encourages his patients to come back for periodic checkups to observe and discuss the long-term results of surgery.

Please remember that the relationship with Dr. Sian does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact Dr. Sian.