The breasts have been and continue to be one of the main symbols of femininity. There are many factors that affect the shape and the consistency of the breasts. Changes like diminished firmness and sagging invariably occur at a certain age. These are all part of the natural aging process. At the same time, factors like loss of skin elasticity, gravity, multiple pregnancies, oversized breasts can also have a negative impact on the appearance of the breasts over the years. Breast changes in terms of shape and consistency can also be accelerated by important or repeated weight fluctuations or even by the weight fluctuations of the breasts that occur in normal life situations such as pregnancy or breastfeeding. This is why sagging can also occur in younger women.The breast lift intervention also called lifting mammoplasty or mastopexy is the only solution that really works on sagging breasts. This imperfection can only be treated with plastic surgery.No amount of creams, massages or physical exercises can reduce the ptosis of your breasts.If the patient is content with the volume of the breasts and only wants to modify the shape and the feature, then the surgical procedure is focused on reshaping and contouring techniques. If the patient also wants an increase in the volume of the breasts, then a combination of mastopexy with silicone implants will usually be recommended by the plastic surgeon.Main indications for breasts lifting:– The procedure is recommended for patients who understand that this is a surgical intervention that involves the presence of a permanent scar, bigger or smaller depending on the method used and the position of the incisions;– Patients who have a certain level of sagginess in the breasts, with or without the reduction of the volume because this imperfection has psychological implications affecting self-esteem and self-image;– Patients who have fully developed breasts;– Patients who are emotionally stable and have a serious motivation for undergoing this surgery;– Patients with realistic expectations from the surgery. The intervention will significantly improve the appearance of your breasts, but perfection is never guaranteed.Terms and definitions for the mammary ptosis:Mammary ptosis is the medical term that defines breasts sagging. It is one of the most common conditions treated by plastic surgeons. There are several classifications of breast ptosis with two main groups and three subcategories. The level of the ptosis being described is a combination of the two.1. The position of the mammary gland compared to the inframammary line: A – partially under the line; B- predominantly under the line; C- completely under the inframammary line.2. The position of the nipple and areola compared to the inframammary line.Stage 1 ptosis: at the level of the inframammary line;Stage 2 ptosis: up to 3 cm under the inframammary line;Stage 3 ptosis: more than 3 cm under the inframammary line.After the initial consultation, the plastic surgeon will be able to tell you the degree of breast ptosis that you have and discuss the types of interventions that are suitable for your case. Together, you can choose the optimal solution. The plastic surgeon will also discuss with you the position of the nipple and areola complex. Tell your surgeon what you want as this will help the plastic surgeon understand your expectations better and determine realistically if they can be achieved.The plastic surgeon will examine and measure your breasts and take photos. The shape, size, quality of the skin and the position of the nipple and areola will also be evaluated.It is always a good idea to show up prepared for the consultation and to discuss your medical history with the surgeon. Don’t forget to mention any allergies, medical treatments or other surgical interventions you went through in the past.It is also important to let the surgeon know if you are planning to lose weight and especially if you noticed your breasts getting smaller and saggy after weight loss. The surgeon will recommend that you maintain a stable weight for at least six months before undergoing surgery.The results after the breast liftThe breast lift represents an intervention meant to remodel the shape of the breasts and to reposition them by surgically removing the excess skin and creating a new external shell (a skin bra), adapted to the volume of the breasts (practically the dimensions of the mammary gland will stay the same, it will only be more elevated after the surgery). If the patient also has minor asymmetries, it will be corrected by removing some breast tissue to create a more balanced look. Most times, the surgeon may also need to remodel the dimension of the areola in order to be proportionate with the new breast. Usually, during the breast lifting intervention, the plastic surgeon can also correct shape or volume asymmetries of the breasts. Removing excess skin in the breast will leave behind a scar. The scar’s shape and localization can vary depending on the gravity of the mammary ptosis and the surgical method chosen.There are several surgical techniques that can be used to address breast ptosis, with exact techniques dependent on extent of sagging and patient’s desires:1. In cases of mild ptosis and when the patient also wants an augmentation of the breasts,, silicone implants can be used to correct the ptosis. The details about the incision and the technique to be used will be discussed by the plastic surgeon.2. When the patient does not want to have silicone implants, the surgeon will make a circular incision around the areola, which allows the surgical correction of the mild ptosis.3. To correct moderate sagging and do extensive reshaping, the surgeon will use a technique that combines two incisions: around the areola and one running vertically from areola going all the way down towards the inframammary fold.4. For severe ptosis, it is usually necessary to add a new incision in the inframammary line, known as anchor incision.The breast lifting intervention does not usually last longer than three hours and it requires general anesthesia. After the surgery, the patient will stay in the medical facility for at least a day. The post-operative discomfort is minimal after this procedure. Some mild pain can occur during the following days after the surgery and painkillers will be prescribed. Wound healing takes 12 to 14 days. During this time you will need to go for regular checkups and to have your bandages changed. For the first three weeks after the surgery it is especially important to avoid unnecessary arm movements and sleeping on the tummy. For about a month after the intervention, you will be required to wear a supportive and elastic bra. Physical activities without any restrictions can be resumed no sooner than six months after surgery.If you want amazing results after the breast lifting surgery, it is important to remember that the relationship between the patient and the plastic surgeon is not over when the surgery is over. Making sure you don’t miss any of the scheduled checkups, strictly following the doctor’s instructions and getting in touch with him as soon as you see some unexpected change in the breast is essential for the best results of your intervention.After mastopexy, you can expect firmer, shapelier, elevated breasts. The position of the nipple and areola will improve and the size and the appearance of the areolas will be aesthetically pleasing.The post-operative scar will become less visible with time, but it is important to understand that the scars are permanent. In some cases, they will look like fine lines. Other patients might develop more visible scars that can be surgically corrected.If you don’t have any radical weight fluctuations or pregnancy, the shape of the new breasts will remain the same for a long period. Still, do keep in mind that gravity and aging will affect the shape and size of the breasts of any woman even after a successful mastopexy. If after a few years, you are again unhappy with the appearance of your breasts, you can go for another breast lifting surgery.ConclusionThe breast lifting surgery is a method designed to correct sagging breasts by getting rid of the excess skin and restoring a shapelier and aesthetically pleasing shape to breasts. Breasts sagging can occur as a result of the natural aging process, multiple pregnancies as well as other factors such as a poor skin quality, loss of elasticity and laxity.The results of the breast lifting procedure are impressive, and they can last for a long period of time. However, the breasts will again be affected by gravity and the passage of time. Keep in mind that the breast lifting procedure can be performed again after several years if the results of the surgery have been altered with time or by other factors.