Introduction Have your breasts lost their firmness, smoothness and softness? What can you do to correct drooping breasts or mammary ptosis? If your breasts look like they have collapsed and you are considering breast augmentation then maybe a breast lift (mastopexy) is a better choice. The implants have an obvious impact on the breast volume. However, they can’t make saggy breasts look perkier. On the contrary, the breasts will be even more likely to sag due to weight of the implants. In this case, a breast lift gives the best result and can be combined with an implant placement to increase the volume of the breasts. With a mastopexy or a breast lift, we can also reduce breast volume and correct ptosis. All issues related to specific treatment options are discussed during consultation with the plastic surgeon. Even if you can evaluate yourself at home and get an idea where you need a breast lift with or without an augmentation or see before and after pictures of patients who have undergone the procedure online, it is only after a proper evaluation and consultation can you determine the most suitable procedure that will improve your appearance significantly. Plastic surgery for breast lift With multiple pregnancies, age or weight loss, your breasts can lose their firmness and elasticity. Exercises, massages or creams do not provide a good solution. A surgical correction, on the other hand, makes it possible to raise the drooping or softened breasts. Such an intervention is never the same for two patients, it depends on the anatomy and desires of the patient. Sometimes the plastic surgeon simply removes excess skin and moves the nipple and areola complex. In other cases, the placement of a breast implant gives the desired result. The surgeon will discuss the most recommended solution with you. Depending on the type of operative method to be used, the surgical procedure lasts between two to three hours with the patient usually under general anesthetic. The length and the complexity of the intervention are also dependent on the amount of skin to be removed during the lift. What are the different methods to correct mammary ptosis? We have started discussing the breast lift surgery, but we also need to mention that there are different operating possibilities to give your breasts their firmness and perkiness. The most frequent breast lift methods are: Breast lift: elevation and centering of the mammary gland with an excision of the excess skin and the reposition of the nipple and areola complex Breast lift with implant: elevation and centering of the mammary gland and the elimination of excess skin and the reposition of the nipple and areola complex and the insertion of breast implants Breast lift with skin envelope Each of these methods has their advantages and disadvantages; there is no standard golden rule. During the initial consultation, your plastic surgeon will advise you on the most appropriate treatment method that will give you the best possible result. The breast lift surgery will make the shape of your breasts more appealing and perky. However, you can’t augment the size of your breasts by just undergoing a breast lift. When you try to pull your breasts up when standing in front of a mirror to see the results that the procedure can offer you, you don’t actually get a realistic image. You might have noticed that if you do this, your breasts will not only look perkier but also somehow bigger. The reality is that during the breast lift surgery, aside from repositioning the mammary gland, the plastic surgeon will also excise the excess skin and fat tissue. This means that some volume of the breasts will actually be lost during this intervention. Sometimes you can lose up to 20% of the breast volume after surgery. In many cases, patients that are not aware of this before undergoing the procedure are disappointed with the result. This is why it is important that the plastic surgeon makes you understand how the breasts will look after surgery. This is also the reason why many patients choose to combine the breast lift intervention and breast augmentation with implants. This way, not only that the breast ptosis is corrected, but the breasts get bigger after the procedure. Breast lift in a few words: Removing excess skin Repositioning the nipple and areola complex Repositioning of the mammary gland tissue The volume of the mammary gland tissue of the breasts remains intact It is important to mention that during a breast lift surgery, the mammary gland remains intact. We only remove parts of the mammary gland tissue during the breast reduction surgery. During mastopexy, the mammary gland is raised and tied up a little higher on the chest muscle. The excess skin is eliminated, the nipple is generally repositioned. When it comes to this type of surgical procedure, the plastic surgeon often carries out two incisions: the first around the areola, the second from the areola to the fold under the breasts. To obtain a good aesthetic result, a third incision is sometimes necessary (in the fold under breasts that are very voluminous and sagging). Firming of the breasts by using implants If the volume of the mammary gland is not enough, the nipple is too high and the skin is still elastic, you can benefit from a simple breast augmentation with an implant. There is no skin removal involved. The mere insertion of a breast implant has the effect of raising the breasts. The small scars are hardly visible. However, this is possible only if breast ptosis is minor to none. A breast lift can be combined with a breast implant surgery. The breast volume usually seems superior after a breast lift because the gland is repositioned in the right place. By removing excess skin that is too soft and repositioning the mammary gland, your breasts become firmer. If you want a higher breast volume, we recommend a breast lift with implant. Enhancement of the nipple If the nipple has sagged a great deal, an aesthetic result can be obtained only by its displacement, at the cost of a scar surrounding the nipple and descending vertically towards the fold under the breasts (just like a breast reduction operation). One can take advantage of the operation to enhance the appearance of the nipples that are too prominent or irregular. Breastfeeding is generally possible after breast augmentation, but this depends on the surgical technique used. If this seems important to you as you are considering a future pregnancy, talk to the plastic surgeon during the initial consultation. Breast lift with implants in a few words: Removing excess skin Repositioning the mammary gland tissue Repositioning the nipple and areola complex Inserting of the breast implants under the mammary gland or pectoral muscle Details of the breast lift combined with the breast augmentation surgery: If the nipple and areola complex is moved, their sensitivity and response may be temporarily attenuated. But in general, sensations are recovered after a few weeks or months after the surgery was performed. However, a permanent loss of nipple sensation may occur as a result of disturbance of blood supply, resulting in partial or total loss of the nipple. This is a very rare complication that usually occurs in patients who smoke. In most cases, breast correction surgeries are completely successful and offer amazing results without complications. Mastopexy: what kind of anesthesia is suitable? By the progress of anesthesia techniques, cosmetic procedures are now possible without having to expose themselves to the side effects of general anesthesia. For the most part, this is the anesthesia of choice for breast lift. As a general rule of thumb, the patient is up from the bed a few hours after the operation, spared by the unwanted side effects of a traditional anesthesia. However, general anesthesia can’t always be avoided. If the procedure is lengthy and complex, it is better for the patient to receive general anesthesia for this surgery. Conclusion The breast lift with or without breast augmentation is a highly personalized and customized procedure. Your plastic surgeon should be board-certified and have plenty of experience. During the initial consultation, the plastic surgeon will determine whether you are a candidate for a breast lift. He will evaluate your breasts tissue, takes into account your body constitution, and advises you what treatment is best suited to meet your expectations. In some cases, the breast lift is recommended to be combined with a breast augmentation with implants, especially if the patient has little breast tissue before the procedure. In other cases, there will be no need for implants if the breast ptosis is minor as the insertion of those can elevate the breasts.