Introduction Most of us associate saggy breasts with old age and a lack of sex appeal. However, aging is not the only factor that can cause the drooping of the breasts. In some cases, breast ptosis as it is called in medical terms can occur quite early in the patient’s life and trigger the unsightly appearance of the breasts. The good news is that nowadays we have a safe and efficient method to correct saggy breasts. This is the breast lift surgery, also known as mastopexy. The position of the breasts on the chest wall, as well as the excess skin envelope of the breasts, can be corrected by the plastic surgeon using different techniques adapted to the needs and physical characteristics of each patient. Depending on the skin quality, glandular tissue, as well as the wishes and the anatomy of the patient, the plastic surgeon will decide towards one operative plan or the other. In this article, we will discuss more what mastopexy can do, but also three limitations of the surgery. What can mastopexy do? Generally speaking, the breast lift entails the removal of the excess of skin present on the breasts, the repositioning of the nipple and areola complex in a correct anatomical position, and the remodeling of the glandular tissue to achieve a durable and aesthetic result. The ideal candidate for mastopexy is a woman with a stable, normal weight who has no plans to get pregnant in the future. It is important to mention that having a breast lift won’t have any impact on a potential future pregnancy or the patient’s ability to breastfeed; however, the appearance of the breasts after pregnancy or breastfeeding might alter the effects achieved with the procedure and deem as necessary another procedure on the breasts. Another factor that can ruin the result of the breast lift and should be avoided is weight fluctuations. When weight loss or weight gain occurs, the breasts can change their beautiful shape and position on the chest wall, and sagginess can occur once again. Before scheduling the breast lift, it is important for patients to know all the details of the procedure and also what the procedure can’t do for them. Beforehand, the patient will need to get some medical tests done, including a breast echography or a mammogram. The procedure can only be scheduled if the results of the tests are within normal limits and the mammogram shows no unknown tissue or formation in the breasts. Often, the breast lift is performed with the use of the general anesthesia for the wellbeing and comfort of the patient who will suffer no pain during the procedure and have no recollection of the operation. The change in the appearance of the breasts occurs immediately after the procedure; however, for the final results to transpire the patient is advised to wait a few months until the side effects of the procedure have completely subsided. The recovery period can be associated with mild levels of pain and also a minor physical discomfort, but these can easily be alleviated with the help of analgesic medication that will be prescribed by the plastic surgeon. Antibiotics are also prescribed for five days post-op to avoid the risk of developing an infection. A strict post-operative protocol is advised after the breast lift to help the patient avoid potential complications and ensure a good final result. Just like any other surgical procedure, there are potential complications that can occur after the procedure such as hematoma, seroma, infection, and changes in the sensitivity of the breasts, among others. Other complications that can occur are unsightly scarring, slight asymmetries of the breasts, fat necrosis, and others. In rare cases, the patient might require revision surgery to correct the effects of the complications left on the breasts. The post-operative scarring after mastopexy is different from patient to patient depending on the level of breast ptosis and subsequently, the surgical procedure chosen by the plastic surgeon. The scars can vary from a circular scar around the nipple that is used for a minor level of breast sagginess, to a circular and vertical scar and even circular, vertical and horizontal scar in severe cases of breast ptosis. The circular scar is positioned exactly at the edge of the areola, so in case of a good cicatrization process, this scar is barely visible due to the natural differences in color in the area. The horizontal scar is positioned in the inframammary fold under the breasts, so it is also well-hidden in the natural folds of the body. The vertical scar goes from the edge of the areola to the inframammary fold and has the potential to be the most visible one. Limitations of mastopexy It won’t reduce the size of your breasts considerably If the sagginess occurred early in life as a result of having overly large breasts, patients should know that just by undergoing the breast lift, their breasts won’t become much smaller. The breast lift will eliminate the excess of skin present on the breasts but has no effect on the volume of the glandular tissue that is often the cause behind mammary hypertrophy. When the breast lift is performed, the breasts might look smaller, especially if the sagginess is severe, but the procedure won’t reduce the size of your breasts considerably. It won’t radically change the shape of the breasts There are many patients who tend to believe that they can choose the shape of the breasts after the breast lift is performed. Most women prefer to have that upper pole fullness that gives the breasts a round and perky appearance. However, the breast lift can’t give you that fullness of the upper part of the breasts. Moreover, keep in mind that mastopexy won’t radically change the natural shape of your breasts as what happens during the procedure is for the plastic surgeon to re-center the glandular tissue on a correct anatomical position. If you want to have a specific shape of the breasts, the recommendation is to discuss this with the plastic surgeon as he might recommend you to get implants aside from the lift. It won’t bring breasts closer together or change their position on the chest wall When the breast lift is performed, the plastic surgeon can correct the size and position of the nipple and areola complex. However, it can’t change the position of the inframammary fold. Some patients have naturally low inframammary folds and want to resort to mastopexy to elevate this fold. This is not possible. However, the plastic surgeon can help you achieve more harmonious looking breasts by correcting the excessive sagginess and the position of the nipple and areola complex according to the position of the inframammary fold. Another aspect that you need to understand about the breast lift is that it won’t bring your breasts closer together. Even after the sagginess is corrected and the breasts will be perky and elevated on the chest wall, it doesn’t mean they will be closer together. The distance between the breasts can depend on many factors, but mainly it is the dimensions of the thorax. A wide thorax often means breasts that are further apart. This aesthetic imperfection can successfully be corrected by using the right type of bra, rather than using plastic surgery for it. Conclusion The breast lift, also known as mastopexy, is the procedure performed to correct saggy, droopy breasts which have lost their sex appeal. The procedure is recommended mostly for women who don’t plan to get pregnant in the future and can sustain a constant, normal weight. The procedure can provide spectacular results for a vast majority of patients, but it also has some limitations worth mentioning. For example, the breast lift won’t bring your breasts closer together on the chest wall or elevate the position of the inframammary fold in case it is too low on the chest. At the same time, the breast lift won’t considerably increase or decrease the volume of the breasts. The procedure strictly targets the skin envelope excess and the remodeling of the mammary gland tissue. This means that it is not a suitable option for women who want to achieve a breast reduction or augmentation. Also, the procedure can’t provide spectacular results for women who want to get upper pole fullness.