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Mastopexy Breast Lift and ptosis

Information in spanish

What is breast lift or mastopexy?

Breast lift, also called mastopexy, is a surgical procedure which is used to lift sagging breasts (ptosis) that have lost their firmness. The word “mastopexy” means fixation of a pendulous breast, but in mastopexy tissues are only repositioned. Breast lift can be performed in healthy women of any age.

This procedure is not advisable for women who are pregnant, girls that have not yet completed their growth or women who are in the post-partum period. It is important to understand that a fertile woman who has had a mastopexy and after some time gets pregnant, she might require a new surgery to reshape breasts. If you have considered losing weight, it is better to do it before having the breast lift.

Mammary ptosis

Ptosis is a condition characterized by the progressive drooping of breasts.

Also, ptosis is a natural part of the aging process in women, which may be the consequence of hormonal changes, pregnancy, breastfeeding, gravity and obesity. Ptosis occurs when the tissue support structures in the breast become stretched and weakened.

Breasts, which contain the mammary glands, do not have muscular structure for exercising response. That´s the reason why efforts for improving breast tone and firmness are unsuccessful.


Preventing saggy breasts:

  • Wearing a bra all the time may delay the effects of gravity on breasts.


  • Select the correct size and style of bra that gives you the comfort and support your breasts need.


  • Breast ptosis will occur any time, with or without implants.


  • Although many women with implants go without bra, it is advisable to wear a support bra to help preventing saggy.


  • Try to maintain your weight. Avoid rapid or frequent changes in weight, as they may affect the support structures of breasts.


  • Breastfeeding is a beautiful experience for the mother and the baby. Do not refrain of breastfeeding because of fear to ruin the shape of your breasts.


Photos Mastopexy Photos Mastopexy

The candidate to mastopexy

Breast lift is recommended for women with pendulous breasts and adequate breast tissue, in other words when breasts present ptosis and excessive stretched skin. If the patient has enough breast tissue, the surgeon may sculpt a conical breast without using implants. While if patient´s breast are sagging but small, the surgeon may recommend implants.

Preoperative breast evaluation and nipple position

The distance from the collar bone to the nipples defines the breast height in each woman. For Latin women this distance may be from 18 to 29 cm. This distance increases in taller women from 21-22 cm, and for small stature women there is an average distance of 16, 5-17 cm. Since the body is not perfectly symmetric, the preoperative evaluation confirms the natural differences in the size and shape of the breasts. Most women surprisingly find that one breast is slightly different than the other.

Another important measurement is the space between the breasts. This distance may vary according to the shape of the women´s thorax.

This measurement should be taken with the patient lying down with the face up. Breasts´ position describes the exact distance between them. In this position, breasts should not move more than 2-3 cm.

In the preoperative evaluation for mastopexy, the nipple position in relation to the inframammary crease should be evaluated. If the nipple is under the inframammary crease, with the patient in erect position, breast implants along with mastopexy should be considered.

In the same way, determining the correct volume of breasts and the appropriate level of the nipple-areola complex should be evaluated. Also, the position and shape of the breasts in relation to the height and weight of the patient are critical when planning a mastopexy.

Types of Mastopexy - What types of mastopexy do exist?

Simple mastopexy

The simple mastopexy is the surgical procedure aims to correct mammary ptosis, in patients who want to lift and reshape their sagging breasts. Usually patients with ptosis have an excess of breast skin, therefore the surgeon may elevate the nipple-areola complex and remove the redundant skin. Women with large flattened breasts may benefit from the addition of breast implants. In some cases, the surgeon may use the pectoralis major muscle to support part of the glandular tissue of the breast.

Dermal mastopexy In some cases to restore the shape of breasts, it is only required to reshape the cutaneous covering or skin covering. If adequate breast volume exists, the body of the mammary gland is not affected. This procedure is called dermal mastopexy.

During the procedure, the surgeon removes the redundant skin and approximates the cutaneous covering using the dermis to reshape the breast mound. This technique involves the excision and lift of the nipple-areola complex. This procedure leaves the breast with a vertical scar (inverted T) that runs around the nipple-areola complex, like a lollipop with a horizontal incision (excess of skin and fat removal) that lies in the crease beneath the breast. These scars are the resulting effort of the surgical technique to restore the position and shape of the breast mound.

The surgeon will evaluate the level of ptosis to adequate the most suitable technique.

Dermal mastopexy can be applied to correct those mild breast asymmetries through the adjustment of the taller breast at the level of the inframammary fold. In some cases where there is not sufficient volume to reshape the breast mound, it may be necessary to place an implant in the subglandular position. After the surgery, a gauze dressing is wrapped around the breast and chest, which should be used for at least 2 weeks.

Mastopexy with breast augmentation

Today, mastopexy with breast augmentation is one of the most commonly performed plastic surgery procedures. Many women undergo breast lift with implants. While in the simple mastopexy the surgeon removes the redundant skin, the mastopexy with augmentation involves a combination of procedures to raise the sagging breast by using the skin envelope to content the implant.

This procedure is suitable for women with no excessive skin, in which the nipple is slightly above or directly in front of the inframammary crease. For those women with severe ptosis and significant breast volume and excessive breast skin, the breast reduction surgery should be considered. In the breast reduction surgery, the physician may accommodate mammary volume without using implants.

Mastopexy and Breastfeeding -Is it possible to breastfeed after breast lift surgery?


Mastopexy and Breastfeeding

Is it possible to breastfeed after breast lift surgery?

It is clear that breastfeeding after mastopexy might be difficult. The elevation of the nipple-areola complex might potentially cause nerve and duct damage making difficult to breastfeed. Preservation of the lactiferous ducts will determine breastfeeding possibility.

Photos Mastopexy Photos Mastopexy

Postoperative recommendations –
Breast lift surgery


What care should be taken after breast lift surgery?

Part of the success of surgery depends on the postoperative care. It is very important to follow the surgeon´s recommendations to achieve the desired outcome. Dr. Nieto closely observes her patient´s convalescence and healing. Please do not hesitate to contact her if you have questions or concerns. Written instructions will be given for your postoperative care to you and your family.

  • A surgical dressing or soft bra must be worn for the following 2 weeks both day and night. Please do not remove it


  • Drainage tubes will be removed usually within 24-48 hours.


  • Sutures are removed within the first two weeks following the surgery.


  • Massage therapy may be recommended to reduce risk of capsular contracture. Your doctor may advise you, from the fourth day following surgery, a gentle massage in all directions. This prevents scar tissue from tightening around the implant. However, capsular contracture must be understood as body´s response condition, and it has nothing to do with the surgeon´s skills.


  • Massage therapy must be done softly compressing and rubbing the tissue around the implant as tolerated. Repeat the massage therapy as frequent as possible.


  • You must rest at home for the first 48 hours following surgery.


  • You will be given a prescription with antibiotics and pain medication to minimize any discomfort.


  • Inform immediately to your physician if you develop an unexpected reaction to the prescribed medication.


  • Prior to surgery, you must make arrangements for a responsible adult friend or family member to take you home and take care of you during your convalescence.


  • You have to sleep on your back and keep your head elevated. You may elevate your body on two pillows.


  • Avoid taking any medication that has not been prescribed by your doctor, especially aspirin (acetyl salicylic acid) or aspirin-like products (Ibuprofen, Advil, Motrin or Aleve). These medicines have anticoagulant adverse effects and may increase the risk of bleeding or scarring complications.


  • You should expect some bruising and swelling as a natural effect of surgery.


  • Avoid any activity for 2 weeks after surgery.


  • Do not remove your bandages or surgical bra.


  • Do not raise your arms above your head for two weeks..


  • You should also be careful about lifting your arms over your head.


  • You will not be able to drive a vehicle for the following weeks.


  • Lifting heavy things, animals or children may affect the area of surgery. You must avoid any activity that increases risk of hitting.


  • Do not allow sutures or dressing to get wet until they have been removed.


  • You must avoid shaving the axillary area for 2 weeks after surgery.


  • Do not lie face down for the first 4 weeks or during the time indicated by your physician.


  • Protect yourself from sun exposure for the following 2 months.


  • You should resume your normal daily activities after 2 weeks.


  • Exercise can be resumed 3 months after surgery.


  • Patient must return to the office for general check up as indicated by the physician.


  • You should keep examining your breasts as usually. Ask your doctor to teach you how to do a breast self-exam after mastopexy.


  • It is important to understand that complete healing and final results after breast lift surgery may take from several months to one year.


  • You should see your gynecologist for breast exam as usually.


  • Please inform Dr. Nieto if you present heavy bleeding from the wound, severe pain or chest pressure, high fever (more than 38 degrees), significant redness or severe discomfort.


  • Do not doubt to call Dr. Nieto if you need to clear out some doubt. You will be closely observed during your recovery from surgery.




Breast Lift Surgery Preparation

It is considered you are in surgery from the moment you arrive to the surgical area until the moment you have sufficiently recovered from anesthesia. Before the procedure, your surgeon, anesthesiologist and the nursing staff will meet you in the pre-operative area to discuss your medical condition and answer any question.

The anesthesia - What kind of anesthesia is used for breast lift surgery?
Breast lift surgery is performed under general anesthesia with intravenous induction and inhalation anesthesia. You will sleep through the entire operation, feeling no pain and remaining absolutely relaxed.

The section about Anesthesia provides complete information on this medical practice along with recommendations and instructions.

How long does the breast lift surgery take?

Breast lift surgery may take 2-3 hours to complete, but it may take longer if other procedures are also being performed at the same time.


Patient preparation before surgery

  • Before surgery, you will be asked to remove your underarm hair by using depilatory cream instead of razor.
    The use of razors prior to surgery increases the incidence of wound infection.


  • Patient preparation includes treating the surgical site before surgery, using appropriate antiseptic agents for skin preparation.


  • In the operating room the intravenous therapy or IV will be initiated. The IV is the giving of liquid substances directly into a vein. Through a needle you will receive saline solution, anesthesia, and other medications you may need during surgery.


  • Once you have moved over the operating table, you will be placed in a supine position with arms in abduction. This means that you will be lying down with the face up and open arms. The elbows are cushioned with pillows to prevent any postoperative discomfort.


  • Breast lift surgery may take from 2-3 hours. The length of your hospital stay depends on your health condition after surgery.


Photos Mastopexy Photos Mastopexy

Faqs - Breast Lift Surgery

What is breast lift or mastopexy?

Breast lift, also called mastopexy, is a surgical procedure which is used to lift sagging breasts (ptosis) that have lost their firmness. The word “mastopexy” means fixation of a pendulous breast, but in mastopexy tissues are only repositioned. Breast lift can be performed in healthy women of any age.

This procedure is not advisable for women who are pregnant, girls that have not yet completed their growth or women who are in the post-partum period.

It is important to understand that a fertile woman who has had a mastopexy and after some time gets pregnant, she might require a new surgery to reshape breasts. If you have considered losing weight, it is better to do it before having the breast lift.


What types of mastopexy do exist?

Simple mastopexy The simple mastopexy is the surgical procedure aims to correct mammary ptosis, in patients who want to lift and reshape their sagging breasts.

Dermal mastopexy
In some cases to restore the shape of breasts, it is only required to reshape the cutaneous covering or skin covering. If adequate breast volume exists, the body of the mammary gland is not affected.

Mastopexy with breast augmentation
Today, mastopexy with breast augmentation is one of the most commonly performed plastic surgery procedures.

What kind of anesthesia is used for breast lift surgery?

Breast lift surgery is performed under general anesthesia with intravenous induction and inhalation anesthesia. You will sleep through the entire operation, feeling no pain and remaining absolutely relaxed. The section about Anesthesia provides complete information on this medical practice along with recommendations and instructions.


Is it possible to breastfeed after breast lift surgery?

It is clear that breastfeeding after mastopexy might be difficult. The elevation of the nipple-areola complex might potentially cause nerve and duct damage making difficult to breastfeed. Preservation of the lactiferous ducts will determine breastfeeding possibility.

What care should be taken after breast lift surgery?

Part of the success of surgery depends on the postoperative care. It is very important to follow the surgeon´s recommendations to achieve the desired outcome. Dr. Nieto closely observes her patient´s convalescence and healing. Please do not hesitate to contact her if you have questions or concerns. Written instructions will be given for your postoperative care to you and your family.

Photos Mastopexy Photos Mastopexy