Introduction The shape and firmness of the breast can be affected over time by many factors, some of them not even known by us at this point. Loss of skin elasticity, pregnancy, weight fluctuations, extreme diets, or breastfeeding can all affect the shape of your breasts and also their position on the chest wall. To this we add gravity and the natural aging process, which changes the breasts structurally. The breast tissue loses its volume, skin elasticity, and tonus, resulting in breasts that have an abnormally low position on the chest wall and a deflated appearance with an empty upper pole. Breast lift or mastopexy, as it is known in medical terms, is the solution to all these problems. Mastopexy is in fact the only effective method that can be used to correct breast ptosis once it occurs. When the breast lift is performed, the plastic surgeon will correct the shape of your breasts and give you an attractive neckline with firmer and perkier breasts. What is mastopexy? Mastopexy is a surgical procedure during which the plastic surgeon will re-center the mammary gland tissues, remove the excess of skin tissue, and give the breasts an elevated appearance, all without altering the volume of the breasts. At the same time, patients can also discuss with the surgeon the reduction of the size of the areola, and also the repositioning of the nipple and areola complex if the breast ptosis is severe. For patients struggling with volume aside from the sagginess of the breasts, the plastic surgeon can recommend a combination of the breast lift with either implants or breast reduction. Many patients ask us if it is possible to get fat transfer when the breast lift is performed. They think that the combination of breast lift with fat transfer can refine the shape of the breasts furthermore. While in theory this could be a good idea, in practice it doesn’t work. The fat won’t survive in the new environment after the breast lift, so it is preferable not to combine the breast lift with fat transfer. However, spectacular results can be achieved when using implants for the breast lift. Mastopexy is not mandatory to be performed with a volume altering procedure. The breast liftin itself can deliver amazing results when performed by a talented, experienced board-certified plastic surgeon on a patient with a good indication for the procedure. However, nowadays more and more patients decide to have the volume of their breasts altered since they are having a breast enhancement procedure either way. If during the procedure the plastic surgeon also inserts implants, the appearance of the breasts will be much more dramatically changed and the results more visible and spectacular. However, it is important to pay a lot of attention to the recommendations of the plastic surgeon when choosing the right type of implants to be used with a mastopexy. When the volume of the breasts after the surgery is excessive, it could trigger breast ptosis again and alter the results. This is also the reason why the plastic surgeon might recommend breast reduction if the patient has breasts that are excessively large compared to the rest of her anatomy. When is it recommended to get a mastopexy? There are different periods in a woman’s life when the sagginess of the breasts can become a problem. Breast ptosis doesn’t affect women of the same age. We can have teenagers with large breasts and sagginess, young mothers with multiple pregnancies, or women after a certain age whose breasts have been affected by gravity and the natural aging process. Before and after the surgery, the breasts of a woman change all the time. They can lose their natural beauty due to several causes that can affect the patient sooner or later in her life. Even genetic predisposition can be among the causes of breast ptosis. Also, the nipple and areola complex can get much wider with the passing of time and get an unwelcoming appearance. When the breast lift is performed, the whole appearance of the breasts is rejuvenated and will look firmer and younger. Typically, women resort to such surgery after a sudden and dramatic decrease in weight, after giving birth, after breastfeeding, or after menopause. Conditions to be met by women who are interested in undergoing mastopexy: – The patient has to be at least 18 years old; – The patient should be in good physical, emotional and mental condition; – The patient should have no medical contraindications to undergoing plastic surgery; – The patient should be able to stop smoking for a minimum of three weeks before and after the surgery; – The patient should be able to take at least two weeks off from work for the recovery period. Aside from these conditions, the plastic surgeon will also ask you to consider carefully if you want to get pregnant again in the future, and if so, maybe to postpone the procedure until you are done having children. If you decide to undergo a breast lift, the doctor you choose should be aware of your entire medical history, including previous surgery (if any), with the treatments administered. Make sure to discuss with him clearly and openly about current medication and potential allergies as this can ensure you have a smooth and fast recovery process and avoid major complications. Results of mastopexy Immediately after mastopexy, the patient will notice that the breasts have an improved position on the chest wall, with a different consistency and perkier. However, in the first weeks and even months, the patient will also be confronted with the normal side effects of the surgical trauma. As it happens with any type of surgery, the breasts will be swollen and bruised after undergoing a breast lift. This will make it difficult for the patient to evaluate the results. In the first three months post-op, the recommendation is to be patient and to avoid assessing the results. Make sure to schedule and attend the follow-up consultations with the plastic surgeon to allow him to monitor your recovery. After the procedure, you will see the plastic surgeon within a day or two, then after one more week and then after a month from the procedure. The follow-up consultations that are next will be scheduled three and six months post-op. Assessing the results 6 months post-mastopexy After the initial three months post-op, most of the side effects associated with undergoing a breast lift will have disappeared for most patients. This means that the plastic surgeon can finally assess the results. At this time, the breasts should look natural, perky, with the nipples facing forward and with the majority of glandular tissue positioned over the inframammary fold. The nipples should face in the same direction and be in the same position on the breasts. The general appearance of the breasts should be perky and youthful, and the incisions should be completely closed and almost healed. Of course, it can take up to three or even six more months for the cicatrization process to be completed, but six months post-op we should have a clear image about how the scars will look like. At this time the patient should be able to perform all activities just like before the surgery, including physical exercises. There are few complications associated with undergoing a breast lift, and many of them can be avoided if the patient will choose a talented, experienced board-certified plastic surgeon to play out the procedure and follow his recommendations to the letter. Conclusion Mastopexy is a procedure that can help patients get the beautiful breasts of their youth back. The aim of the procedure is to create firm and perky breasts that have a normal appearance and a correct position on the chest wall. During mastopexy, enlarged areolas can be corrected as well. The plastic surgeon might also recommend combining the breast lift with implants and even a breast reduction, depending on the anatomical characteristics of the patient and her aesthetic goals. Keep in mind that the results can take more than three months to occur and it is only after six months that it is recommended to assess the final results. For the cicatrization process to be completed, a few more months might be necessary.