As part of the natural aging process, women lose skin elasticity in their breasts, gravity takes its toll, and breasts become less “perky”. Genetics, pregnancy, breast-feeding, and weight loss can all produce similar results. When this occurs, some women become unhappy with their appearance and wish to return to their more youthful look. In these cases, a breast lift or mastopexy can reduce or eliminate sagging, and for women seeking enhancement in size, can be performed in conjunction with implants to increase the breasts' volume. The goal of a breast lift is to elevate the nipple to a higher position and to tighten the breast skin and tissue from below.

General Description
Three basic techniques are used for breast lift surgery with or without implants: concentric mastopexy, vertical mastopexy, and anchor-shaped mastopexy. Breast implants are usually placed partially under chest muscle and can be saline-filled or the newer silicone gel-filled implants. Your plastic surgeon will be able to review these options with you.

Concentric Mastopexy
During concentric mastopexy, a circular incision is made around the areola as well as a second inner circle to allow the areola to be made smaller. The size of the outer circle depends on how much lift is to be performed. The skin between the two incisions is removed and the nipple and areola are repositioned upward. The surrounding larger circle is closed like a drawstring around the smaller areola. Because there is a relatively small amount of skin removal, this technique only works for women with smaller breasts and minimal sagging. If an implant is used, it can be placed through the same incisions leaving the only scar around the areola.

Vertical Mastopexy
For more breast sagginess, the incision needs to be extended vertically down the midline of the breast from below the areola to the breast crease. This allows an additional strip of skin to be removed, giving your plastic surgeon the option of greater correction. The resulting scar will be around the areola and down the middle.

Anchor-Shaped Mastopexy
This procedure allows for the most correction with or without an implant. An incision is made above the nipple in the shape of an anchor, with a circle at the top. This incision forms the shape of the new breast with the nipple placed in the circle at the top of the anchor, and the elliptical line at the bottom forming the lower contour.

Recovery / Post Op Expectations
After your surgery, you will have dressings placed and typically held in position with a surgical bra and/or an ace wrap. Bruising, swelling, pain, and discomfort will be experienced for the first few days depending on the type of surgery you had. Your plastic surgeon will review what your activity restrictions and post-operative care will involve.

Potential Complications or Adverse Outcomes
In addition to complications possible with any major surgery, mastopexy carries with it some risks patients should be aware of prior to surgery, including:

· Asymmetry (left and right not being the same)
· Change in sensation of the nipple and/or breast tissue
· Potential poor healing of the nipple and areola due to decreased blood supply
· Scarring
· Irregularity in nipple position
· Discoloration of skin and nipple
When implants are used in conjunction with a lift, additional risks including implant leakage and interference with mammograms are possible.

Who is a candidate?
Any patient with excess sagginess of their breasts with a desire to have some correction and/or increased fullness is a candidate. Though surgery does not usually interfere with breast-feeding, it is best to not have surgery if you plan on becoming pregnant in the future as this could negate the results of surgery. Your weight should be relatively stable and if you smoke, your plastic surgeon will require that you are free from any exposure to tobacco products for two to four weeks before and after surgery to decrease the risks of complications.