Introduction The breast lift (also called in medical terms as mastopexy or ascending mammoplasty) is the surgical procedure performed to lift and reshape the breasts. By undergoing mastopexy, it is also possible to reduce the size of the areola (darker skin around the nipple), and saggy breasts will gain a more natural shape by adjusting and repositioning the breast tissue in a suitable position on the chest wall. If your breasts are low or have a small volume compared to the rest of your anatomy, implants can often be inserted in combination with the breast lift to increase the size and firmness of the breasts. Many people end up considering undergoing a breast lift even if they initially just wanted to get implants. This is often the case of women after a certain age, as breast ptosis is accelerated by the passing of time and if the patient has certain unhealthy life habits. In this article, we will discuss details about mastopexy and how it can help you. Candidacy for the breast lift It is only after a consultation with the plastic surgeon that you can be deemed as an eligible candidate. If you are in a good physical and mental condition, you have realistic expectations, you have no tumors or unknown formations in the breasts, then chances are you might be a suitable candidate. You will need to undergo a mammogram before surgery if you are over 40 years old or a breast echography if you are younger. Also, the plastic surgeon will recommend a set of tests to be performed before scheduling the procedure and meeting with the anesthetist to discuss the type of anesthesia used for your surgery. An experienced plastic surgeon will tell you that we can achieve spectacular results for patients with saggy breasts if they are committed to following the post-op recommendations. The results tend to last longer for patients who have a normal size of the breasts compared to women with overly large breasts. Keep in mind that the procedure can be performed on women of different ages and the volume of the breasts is not important for the breast lift; however, it can make all the difference in terms of sustaining the results for longer. It is a well-known fact that smaller breasts tend to keep their perky, youthful appearance for longer compared to larger breasts. The plastic surgeon might even recommend a combination with implants or breast reduction if he feels that it is important for the success of the procedure also to improve the volume of the breasts. When the breast lift is done with implants, the plastic surgeon will use the same incisions created to lift the breasts to insert the implants in pockets. When the breast lift is performed with breast reduction, aside from re-centering the mammary gland and eliminating the excess of skin tissue, the plastic surgeon will also remove a part of the excess mammary gland. When assessing candidacy for the procedure, the plastic surgeon will also ask if you plan to get pregnant again in the future and if your weight has been stable over the last year. These are important questions that you should answer in all honesty as the sustainability of the results is dependent on them. An ulterior pregnancy or weight loss occurring after the breast lift can result in the alteration of the aesthetic results. How can mastopexy help you? In just a few words, the breast lift will help you get the perky breasts of your dreams. This means that after the procedure, your breasts should be in a correct anatomical position on the chest wall, with a normal shape and a full appearance. Most of the glandular tissue should be centered on a position that is above the inframammary fold and the nipples and areolas should have suitable dimensions and facing forward. It is important to understand that new, perky breasts will come at the cost of permanent scarring. The number and location of the scars are dependent on the technique preferred by the plastic surgeon and the severity of the breast ptosis. Surgical techniques for breast lift vary, but the most commonly used techniques involve an anchor-shaped incision that surrounds the areola, extends vertically downward under the areola, and may or may not be accompanied by a horizontal incision located on the inframammary fold, depending on the size of the breasts. The excess skin around the areola is removed, and the nipple and areola are moved to a higher position. The sutures are usually placed around the areola, on a vertical line descending from under the areolas. If your breasts are not overly large and the breast ptosis is moderate, the plastic surgeon might choose to perform a periareolar incision. This means that you will have just an incision around the areola, and no other incisions on the breasts. If silicone implants are to be inserted at the same time, they will be placed in a pocket directly beneath the mammary gland, or more deeply under the pectoral muscle for a more natural appearance if you do not have enough breast tissue to cover the contour of the implants. More commonly, experienced plastic surgeons nowadays can also choose to do a dual plane placement of the implants. This means that the implants will be half under the pectoral muscle and half under the mammary gland. This ensures good coverage for the implants and natural-looking results. Recovery after mastopexy After surgery you might feel tired, and the discomfort will be moderate or more intense in the first two to three days post-op, but that does not mean you have to stay in bed. More likely, the plastic surgeon will advise you to get off the bed as soon as possible despite the discomfort and get moving around the room. A short walk of a few minutes is recommended every few hours as it will help you avoid the risk of the formation of blood clots. Depending on the complexity of your procedure, your breasts will be swollen and bruised, but the pain should not be severe. Discomfort and pain can be controlled with analgesic medication. You will also be prescribed antibiotics for the first five days post-op. It is crucial for a smooth and fast recovery to take the medication as per the doctor’s instruction. Antibiotics are prescribed for a preventive purpose only; however, they are essential in helping you avoid infections that could prolong the recovery process unnecessarily. Most patients don’t experience intense pain after the breast lift. If you do notice that the pain is getting a bit unbearable and if you have other symptoms such as high fever, redness in the area, or pus coming from the incision site, it is important to contact the plastic surgeon immediately as you might have developed an infection that needs immediate treatment. If your plastic surgeon is unavailable and you have signs of infection, you should seek medical assistance at your GP or local hospital. For 6 weeks after surgery, you will have to limit your physical activity. Lifting heavy objects is not allowed for 4 to 6 weeks and even more. Stretching exercises, especially ones involving the upper part of the body, should be avoided for at least a few weeks post-op. The plastic surgeon will monitor your recovery as you will need to schedule follow-up consultations with him. Conclusion The breast lift, also known as mastopexy, can help women with saggy breasts regain the beautiful appearance of the breasts and also a normal position on the chest wall. After the final results, the patient will enjoy perky breasts that look much younger compared to breasts of people of the same age. Keep in mind that the procedure should only be performed on patients after they had a mammogram or a breast echography to rule out any potential contraindications to the procedure. Mastopexy can deliver results easily sustainable over time if the patient manages to keep a constant weight, avoids ulterior pregnancy, and always wears a fitted, good quality bra. Smoking can also alter the beautiful appearance of your breasts, so you should avoid this bad habit as much as possible, especially at the beginning of the recovery period.