How to do a breast lift

O mortal! Like a dream made of stone, I am beautiful!
And my chest, which will destroy everyone in succession,
The hearts of artists are tormented by love imperiously,
Like matter, eternal and mute.
Charles Baudelaire, "Beauty"

A woman’s breasts can be the subject of admiration, envy, lust... A woman’s self-esteem largely depends on her appearance. And this is one of the reasons why plastic surgery to correct the shape of the bust is leading in popularity [1]. Meanwhile, many are afraid of having implants installed. In this case, breast lift surgery—mastopexy—can help correct the shape of the breast. So, how can you tighten your breasts, restore beauty and firmness to your bust, and avoid installing implants?

What problems will a breast lift solve?

There is an opinion that women's breasts undergo the most significant changes during pregnancy and lactation. However, there are other factors that lead to the bust losing its elasticity and shape:

1. Gravity is a natural and inevitable cause of breast loss;
2. age (over time, the glandular tissue of the mammary gland is replaced by looser fatty tissue, and the breasts “sink”);
3. heredity;
4. hormonal changes;
5. weight fluctuations;
6. weakening of connective tissue (this is caused by congenital characteristics, age-related changes, stretching during feeding, etc.);
7. incorrect selection of underwear;
8. smoking (leads to the destruction of elastin fibers) [2].

We have listed the main reasons why breasts lose their firmness, shape and gradually “sink.” This phenomenon is called ptosis. To determine whether and how a breast lift can be done, the doctor determines the degree of ptosis by measuring how much the nipple and soft breast tissue have moved relative to the fold of skin under the breast. If the nipple does not change position, and only the soft tissue of the breast descends, then they speak of pseudoptosis. A downward displacement of the nipple by no more than 1 cm indicates grade I ptosis. If the nipple drops 1–3 cm relative to the skin fold, but remains above the parenchyma (soft tissue of the breast), then they speak of ptosis of the second degree, or moderate. The third degree of ptosis is characterized by the fact that the nipple is directed downwards and moves to the lower part of the parenchyma [3].

If there is ptosis, stretch marks on the breasts, asymmetry of the mammary glands, or pronounced flattening of the breasts, doctors recommend performing a breast lift operation - mastopexy. Surgical intervention helps a woman find psychological comfort and achieve a beautiful bust shape [5]. At the same time, the volume of the breast does not change, its shape improves [6].

Are there any contraindications to breast lift surgery?

There are times when your doctor may recommend postponing your facelift procedure. For example, if a woman plans pregnancy and breastfeeding in the future, or if she is unhappy with her weight and plans to actively lose weight, it is better not to undergo breast correction. Also, the operation is not performed if less than a year has passed since the end of feeding.

Other contraindications for mastopexy are:

1. disruption of the blood coagulation system;
2. endocrinological diseases, including diabetes;
3. acute infectious diseases, exacerbation of chronic diseases;
4. oncological diseases;
5. mastopathy;
6. tendency to form scars;
7. hormonal disorders [7].

How dangerous is the operation?

Patients planning to undergo a breast lift always wonder what complications may arise. Since mastopexy is an operation, after it, as after other surgical interventions, swelling may begin, and the formation of hematomas, seromas, and suppurations is possible.

Another group of complications is associated with the very nature of the operation. The two main problems are secondary ptosis, that is, repeated “dropping” of the breast, a change in its shape, and the appearance of scars [8]. The larger the breast volume before surgery, the greater the likelihood of secondary ptosis. Hormonal imbalances and changes in body weight also contribute to the development of complications [9]. The sensitivity of the nipples may decrease: experts believe that about 15% of operated women face this situation [10].

Before the operation, you need to visit a therapist, mammologist (do a mammogram or breast ultrasound), and an anesthesiologist. Blood and urine tests, ECG, and fluorography are also required. Immediately before the operation, the doctor marks the breast and explains in detail how exactly the lift will be done [11].

What methods of breast lift are there?

During the operation, the doctor solves several problems: pulls the nipple and areola up, removes excess skin that has formed at the bottom of the mammary gland, pulls the entire gland up and fixes the tissue. Depending on the degree of ptosis and breast volume, the surgeon chooses the method of operation.

If the breast is small and the ptosis is not very pronounced (grade I), then the incision is made along a line resembling a crescent in the upper part of the nipple areola or along the line around the nipple (periareolar lift in the Benelli modification and a circular lift, or Benelli lift). This type of breast lift is the least traumatic, leaving small scars, but such a lift can be done if the breast is of small volume and the ptosis has not progressed beyond stage I [12]. After such manipulation, the breasts are slightly flattened, so this method is indicated if the breasts have a pronounced cone shape [13].

For grades II and III ptosis, vertical and anchor lifts are indicated. In the first case, the incision is made along the line around the nipple and vertically downwards. The second also requires a third incision, along the line under the breast. After such an operation, more scars remain, but with serious “sagging” of the breast, a good bust shape can only be achieved in this way.

Any of the described operations is performed under general anesthesia and lasts about 2–3 hours [14].

How is the rehabilitation going?

As after any other operation, after mastopexy the woman remains in the hospital for a day: doctors monitor her well-being, including her recovery from anesthesia. Some patients report pain after surgery, but usually it is mild and passes quickly.

If the patient’s health is good, she is discharged home on the second day with the basic recommendation to wear compression stockings for at least a month. This helps reduce swelling and reduce pain, if any. After about 12–14 days, the doctor removes the stitches. For a month, it is better for the patient not to exercise and not to overheat: she should not visit the sauna or bathhouse.

The result can be assessed 3–4 months after surgery, when the swelling has completely subsided [15].

To maintain breast shape, it is better to avoid serious weight fluctuations and hormonal changes. With properly structured physical activity, the results can be maintained for several years. For example, swimming is considered a good form of physical activity [16].

How much does it cost to have a breast lift?

The cost of breast lift surgery depends on its volume, complexity, and the experience of the surgeon. Today in Moscow the average price is from 170,000 rubles, including hospital stay and the purchase of compression stockings.

Many women dream of restoring the beauty and firmness of their breasts. However, not everyone is ready to have implants installed. Today, doctors can restore the shape of the breast with the help of a lift: performed by a competent and competent specialist, it gives a result that women like and attracts the attention of men. Mastopexy, or breast lift, gives many women a chance to regain their self-confidence.

How to choose a reliable clinic

Plastic surgeon Alexander Sokolov believes that when choosing a clinic for mastopexy, you need to pay attention to the capabilities of the medical center and the experience of the surgeon:

“Where we deal with a person's doubts and expectations in the field of appearance, experience is very important. People are afraid of getting implants because it is something “foreign”. But at the same time they want to look beautiful. Only a specialist who knows different techniques can understand what they need, be able to predict the result, and choose the best way to provide the service.

As a result of the operation, complications may arise that are unlikely to be expected by a woman who decides to have surgery. In particular, secondary loss of shape after a few years. The surgeon's experience can play a decisive role here, so it is important to go to a specialist who is actively working in this area.

Plus, you need to study the capabilities of the clinic where the operation will be performed. The latter takes place under general anesthesia, so the medical center should have the capabilities for both a full-fledged operation and recovery. These are the conditions that have been created, for example, at the Genesis Medical Academy.”

License No. LO-77-01-013134 dated September 15, 2016, issued by the Moscow Department of Health.

Mastopexy is aimed at creating a beautiful shape and high position of the breast by surgically eliminating sagging breast tissue.

Today, mastopexy is one of the most popular and in demand plastic surgeries.

Women who want to improve the volume and shape of their breasts, making them firmer and firmer, turn to mastopexy.

The result of mastopexy depends on many factors:

1. professionalism of the surgeon;
2. individual characteristics of the patient;
3. compliance with doctor's recommendations in the postoperative period.

Possible complications after mastopexy.

When planning a mastopexy, it is important to choose a reliable clinic and a professional surgeon with significant experience in the field of plastic surgery.

On some plastic surgery portals you can attach a photo and get a doctor’s consultation.

1. 1
2. 2
3. 3 ,
4. 4
5. 5
6. 6
7. 7 ,
8. 8 Mikhailov A.G., Rozhdestvenskaya N.K. Mastopexy with endoprosthetics / A.G. Mikhailov, N.K. Rozhdestvenskaya // Plastic surgery and cosmetology. - 2013. - No. 3. — P.375-383.
9. 9
10. 10
11. 11
12. 12
13. 13
14. 14
15. 15
16. 16

After removing the compression knitted underwear, you should stop wearing bras with a hard cup, as well as lace ones, for a month or two. It is better to choose seamless underwear and sports bras. At home, whenever possible, you should wear cotton tops.

If a woman at Balzac's age has high and firm breasts, one can only envy her. In her case, nature practically accomplished a feat by preserving the beauty of one of the most important parts of the female body. Unfortunately, this is such a rare exception to the rule that you will hardly find among your friends at least one lady who, say, by the age of 50, can boast of an elastic bust.

Throughout life, a woman's breasts undergo changes in volume and shape. This may be due to hormonal changes, fluctuations in body weight, and decreased skin elasticity. Most often these parameters change after pregnancy and breastfeeding, although problems can begin to appear even at a young age.

In this case, prolapse of the mammary glands almost always occurs, which significantly worsens the appearance of the breasts and often leads to a certain psychological discomfort.
The appearance of the mammary glands is determined by the condition of the skin, the volume of subcutaneous tissue and glandular tissue, therefore no amount of physical exercise or cosmetic products can affect their shape.

But, of course, there is no need to despair. Because plastic surgery of the mammary gland has been existing and successfully developing for many decades, in particular such a direction as mastopexy. It is a type of mammoplasty in which the breast is given an aesthetic shape.

The operation can change the height of the bust, change its contours and size, as well as remove excess skin and excess fatty tissue. For example, the winner of the Oscar for Best Actress in the film The Watch, one of the brightest stars of world cinema, Nicole Kidman, went through all this. Or another, no less stellar example is the singer and composer Madonna. Finally, the famous TV presenter Dana Borisova turned to plastic surgeons for mastopexy.

The list can be continued for a very long time, because this problem is no less relevant and widespread than insufficient breast size, and often they are combined. In these cases, you have to solve two issues at once - restoring the shape and achieving the desired size. Only an integrated approach can make a woman’s breasts beautiful and achieve the most aesthetic result.

Table of contents

Who needs a breast lift?

The surgeon’s tactics for surgical correction of unsatisfactory breast shape depend on a combination of many factors. First of all, it is the shape and volume of the breast. In a bust without signs of ptosis, the areola is located above the line of the submammary (inframammary) fold. But if the nipples are lower, these are already signs of mastoptosis (or simply ptosis).

There are three degrees of ptosis:

1. 1st degree (mild ptosis) – changes in the breast are minimal, the nipple is lowered to the level of the lower fold of the breast;
2. 2nd degree (moderate ptosis) – the nipples are lowered below the specified line, but they maintain a horizontal position, that is, directed forward;
3. 3rd degree (severe ptosis) - the mammary glands look flat, significantly drooping, nipples point down.

In addition, ptosis is often combined with various types of asymmetry of the mammary glands: in volume, height of the inframammary fold, diameter of the areolas, etc. The original size is also of fundamental importance. Taken together, all these indicators will determine the surgeon’s tactics when choosing a correction option.

The first breast lift techniques were developed approximately 100 years ago. But first things first. To date, there are many options for mastopexy. Exactly 40 years ago, two foreign plastic surgeons, Letterman and Sharter, tried to summarize all the methods known to them by that time. There were four main groups:

1. Breast lift using skin changes only. During this operation, the mammary glands remain intact, only excess skin is removed.
2. A lift is performed by attaching breast tissue to the anterior chest wall. This refers, of course, to its upper layers - skin and muscles.
3. The mammary glands are modified by suturing the glandular tissue, the same one that in the female breast is responsible for the production of milk necessary for feeding the baby.
4. Ptosis is eliminated by breast augmentation using prostheses - implants.

For the first time, the French surgeon S. Girard came up with the idea of ​​attaching upwardly displaced mammary gland tissue to the chest in 1910. This method has become fundamental to most modern mastopexy operations. 13 years later, another method was invented: remove excess skin from the lower part of the breast, and move the nipple and areola to the top.

After another quarter of a century, plastic surgery invented a third method. Improve the breast by moving up the flap, which is located in the lower sector of the breast, and fixing it to the anterior wall of the chest. Subsequently, doctors focused their attention on inventing methods that would improve the female bust without leaving noticeable scars on it. These discoveries were made from 1961 to 1974.

Back in 1966, a new word was said in breast lift: it was said by the French surgeon P. Regno. He proposed correcting grades 1 and 2 ptosis by implanting endoprostheses.

Operation stages

Depending on the severity of ptosis and deformation of the mammary glands, the scope of the mastopexy operation can vary significantly.

If ptosis is mild and is caused by a decrease in the volume of glandular tissue, without excess stretched skin, then breast replacement using implants with a high projection profile may be sufficient to achieve an aesthetic result.

If there is a larger volume of stretched skin, it is necessary to remove them to give the gland harmonious proportions. If the volume of the gland is sufficient, then its shape is corrected using special sutures, and then plastic surgery of the skin tissue is performed.

If the volume of glandular tissue is insufficient, any version of mastopexy is complemented by endoprosthetics of the mammary glands.

Operation methods

Currently, three types of mastopexy are most commonly used.

1. Periareolar mastopexy.

It is performed when ptosis of the mammary glands or their asymmetry is caused by the presence of moderately expressed excess skin. With this type of lift, two circular incisions are made. One of them is around the circumference of the areola (which allows you to adjust its shape and size if necessary). The second, larger in diameter, is around the first. Excess skin between them is removed, then intradermal sutures are placed between these areas. The postoperative scar is located around the circumference of the areola.

2. Mastopexy with vertical suture.

If there is severe ptosis of the mammary glands, performing periareolar mastopexy does not adequately solve the problems. Removal of extended areas of skin between two circular incisions in this case will lead to significant gathering of the outer edge and significant flattening of the mammary gland.

The appearance of the breast after such an operation will be far from natural proportions.
To give the breast a natural teardrop shape in such cases, it is necessary to supplement the periareolar incisions with vertical ones to remove excess skin in the lower sections.

3. Mastopexy with a T-shaped (“anchor”) suture.

With extreme degrees of ptosis of the mammary glands, a horizontal inframammary incision is also required. The additional postoperative suture is located in the submammary fold and does not have a significant effect on the cosmetic result of the operation.

Of course, when planning an operation, preference is given to mastopexy options, after which the number of postoperative scars is minimal. However, in cases of severe ptosis of the mammary glands, when objective initial data require adequate correction, an unreasonable desire to minimize the amount of intervention can lead to unsatisfactory aesthetic results.

Preparing for surgery

Since mastopexy is a serious and fairly lengthy surgical procedure, it is necessary to undergo a full course of preoperative examination to exclude the possibility of adverse consequences due to any health problems. It is required to inform the surgeon in advance about all existing or previously suffered chronic diseases, the presence of drug intolerance (allergies to drugs), and bad habits.

Smoking patients should pay special attention to the fact that for a favorable course of the postoperative period and wound healing, it is advisable to quit smoking for two weeks before surgery and for a month after it.

It is advisable to perform mastopexy surgery no less than six months after completion of breastfeeding (lactation).

If you plan to reduce your weight through diet or special physical activity, mastopexy should be performed after achieving the desired result. Otherwise, sudden weight loss after surgery may worsen the aesthetic result.

Contraindications to such operations are: bleeding disorders, diabetes mellitus, infectious, severe autoimmune, oncological diseases, as well as diseases of the cardiovascular and respiratory systems, which are risk factors for general anesthesia.

If there are no contraindications, then the next step will be an examination. After all, the patient may not be aware of possible existing health problems. It is necessary to perform laboratory tests of urine and blood (clinical and biochemical, determination of group and Rh factor, coagulogram (clotting test), tests for HIV, syphilis, hepatitis B and C), electrocardiogram, fluorography, ultrasound of the mammary glands.

A week before surgery, you need to stop taking medications that affect blood clotting. On the day of surgery, you should not eat or drink anything.

Depending on the degree of complexity, the operation can take from 1 to 2.5 hours. Already in the evening on the day of surgery, patients can get up and eat. The length of hospital stay is usually one day.

Rehabilitation after surgery

Postoperative pain may occur for 1-3 days. After this period, their intensity decreases significantly, and taking tablet analgesics is sufficient.

For a month after surgery, you must wear special compression garments. When mastopexy is combined with breast augmentation, this is necessary to fix the breast implants in the correct position. In addition, wearing compression garments allows you to reduce the load on postoperative sutures, which significantly reduces discomfort and creates conditions for rapid healing of the postoperative wound and the formation of a cosmetic scar.

After discharge from the hospital, you will need to take medications recommended by your doctor. To prevent postoperative complications, antibiotic tablets are prescribed for 7 days. To eliminate possible pain, it is recommended to take analgesics.

For a week after surgery, you should not wet the area of ​​the postoperative wound.

7-10 days after the operation, after the surgeon has assessed the condition of the postoperative suture, you will be able to shower.

It is necessary to avoid physical activity for a month after the operation and intense activity for another two months. After this period, you can return to your normal lifestyle.

It is recommended to refrain from visiting baths and saunas for six months. During the year after surgery, it is necessary to avoid direct sunlight on the area of ​​the postoperative suture (topless tanning), which threatens the occurrence of hyperpigmentation of scars in this area.

Depending on the severity of prolapse (ptosis) of the mammary glands, postoperative scars after mastopexy may have different extent and location. One of them is always located around the circumference of the areola. With severe ptosis, when periareolar mastopexy is not enough to correct it, the postoperative scar may have a vertical component, and, if necessary, also a horizontal one, located in the inframammary fold.

As a rule, the scar located around the areola, due to the fact that it is located on the border of the pigmented and unpainted areas of the skin, is less noticeable than in other areas. Due to its localization, a scar in the inframammary fold also does not worsen the cosmetic effect of the operation.

The vertical scar is most noticeable during the first months after surgery. However, after an average of 6 months, it, like all other scars, begins to fade, acquires a natural color, becomes thinner, more elastic and becomes comparable to the surface of the surrounding skin.

When performing these interventions, modern suture materials of the latest generation are used. Cosmetic absorbable intradermal sutures are applied, which do not require removal in the postoperative period.

To form a minimally noticeable scar and achieve the most aesthetic result in the postoperative period, it is advisable to wear a special silicone patch.

We will also name possible complications after mastopexy. This:

1. infectious complications;
2. hematomas;
3. asymmetric scarring;
4. decreased nipple sensitivity.

Such cases are, of course, very rare. As for nipple sensitivity, it usually returns to its original level within a period of 6 weeks to six months.

The final result of this surgical intervention will not be visible immediately. Moreover, at the beginning, especially after a T-shape lift, the breasts do not look entirely natural, with an overfilled upper pole and insufficiently voluminous lower ones. This is a temporary phenomenon. Over the course of several months, the bust takes on a natural teardrop shape. And when the postoperative sutures become minimally noticeable, patients will be able to appreciate the dramatic changes in their newfound breasts that became possible thanks to this rather complex, but very effective operation.

Scientific editor: plastic surgeon V.S. Bakov

A breast lift or mastopexy is a surgical operation whose purpose is to tighten overly stretched breasts and eliminate ptosis (drooping, sagging) of the breast and skin. This operation should not be confused with reduction mammoplasty, which deals with the reduction of overly large breasts, while the goal of mastopexy is to tighten the breasts. In some cases, both of these operations overlap.

How can you tell if your breasts are sagging?

Many women think that if the breasts do not look lush from all sides, which is typical only for girlish youthful breasts, then a lift is definitely necessary. In fact, normal female breasts are sloping in the upper pole and full and round in the lower pole.

Breast ptosis is determined by the relationship of the nipple and lower pole of the breast to the inframammary fold (the fold under the breast).

Normal breast - the lower pole of the breast does not cover the fold under the breast (or covers it slightly if the breast is very full), the nipple looks forward or upward and is also located above the level of the fold under the breast.

Ptosis 1st degree — The nipple is lowered to the level of the fold under the breast and is in line with it. The lower pole of the chest covers the inframammary fold and descends below it. The nipple is located slightly above the lower pole of the breast.

Ptosis 2 degrees - The nipple may still be above the lower pole of the breast. Moreover, it is below the inframammary fold.

Ptosis 3 degrees — The nipple most often looks down, the lower pole of the breast no longer has rounded outlines and is strongly lowered below the inframammary fold.

Pseudoptosis - the nipple is at the level of the inframammary fold or even higher, but the lower pole of the breast is noticeably lowered and covers the inframammary fold. In other words, in this case only the mammary gland sags, while skin ptosis is weakly expressed.

It is worth adding that breast ptosis is a normal situation, the causes of which are most often: age, gravity (this especially affects large, lush breasts), feeding a child, weight loss, genetics.

When is a breast lift needed?

A breast lift can be done at any of the above stages of ptosis. Moreover, the earlier the stage, the better, since the surgical impact will be less. In general, mastopexy can be performed if:

1. The chest looks like a “pancake”, has no volume and tends to become flat;
2. Nipples point down;
3. The breasts became empty, the areolas expanded in size;
4. The skin of the breast has become very flabby and does not hold its shape at all.

When is a lift + implants needed?

In the vast majority of cases, ptosis of the glandular tissue occurs together with ptosis of the skin, that is, the mammary gland, under its weight, stretches the skin. However, the condition of these two organs will be different. For example:

— The mammary gland loses tone, decreases in size, while the skin still remains quite firm and elastic. In this case, you can limit yourself to just installing implants. True, this option does not occur very often.

— There is both skin ptosis and breast ptosis. At the same time, glandular tissue is quite small. Thus, if you do only one lift, the volume of the gland may not be enough to form a beautiful breast shape. Therefore, the best option here is a lift in combination with implants.

— There is both skin ptosis and breast ptosis. And despite the fact that the mammary gland may be sufficient to form a good breast shape, the patient wants to have a larger volume. In this case, the lift is also combined with implants.

When is one breast lift without implants enough?

Mastopexy can be performed without additional manipulations if:

— A woman has both skin ptosis and gland ptosis, which is enough to create a good shape. The patient, in turn, also does not crave additional volume. Then the doctor performs only a lift, forming a new breast shape with the patient’s own gland.

- Excessively large breasts (including gigantomastia). In this case, breast lift intersects with reduction mammoplasty. Since the breasts require both lifting and reduction in size.

Breast lift + lipofilling

In some cases, breast lift can be performed using lipofilling. If the patient has no particular desire to have large breast volume, or, for example, is allergic to implants, an attractive bust shape can be achieved using the existing glandular tissue, as well as fatty tissue taken from other areas of the patient’s skin (usually the hips and buttocks) .

How is the operation performed?

There are the following ways to perform the operation:

— Implants only — if the ptosis is very slight, breast tightening and filling can only be done with implants without excision of excess skin.

— Periareolar method - the seam runs around the areola of the nipple. Acceptable for mild ptosis.

— Vertical method - the suture runs along the areola and goes down to the submammary fold. Suitable for severe skin ptosis and glandular ptosis.

— Anchor pull-up method - skin is removed from the sides of the breast, around the nipple and along the lower pole. The method is applicable for severe ptosis.

A breast lift is performed under general anesthesia. The duration of the procedure depends on the complexity and volume of work. On average - from 1 to 3 hours.