Introduction Mastopexy is a plastic surgery procedure that enhances saggy breasts by restoring their firmness and youthfulness. If your breasts are saggy or positioned very low, you may consider getting a mastopexy, which is also known as a breast lift. The shape of the breast and the extent to which the breasts can sag differs from one woman to another. As such, the type of mastopexy and the degree of breast lifting required can also vary from one patient to another. Mastopexy has an excellent history of effectively raising the breasts, making them perky and sexy. Different incision options can be used under mastopexy. Each incision type can treat different levels of sagging in the breast. A plastic surgeon can examine your breasts and best tell you as to which incision option is best for you. Why the breasts sag You want to get the breast lift because your breasts are saggy and you desire to improve your breast’s firmness and contour. The reasons why the breasts become saggy are common among all women who suffer from this condition. The breasts sag when the breast muscles separate from each other and become weaker and fail to provide support to the breasts. The condition can be further deteriorated when the skin elastin becomes weaker and fails to keep the breasts in position. The factors that can trigger weakness of the breast muscles and skin include multiple pregnancies, having huge breasts, massive weight fluctuations, aging, heredity, and poor lifestyle. When the breasts sag, not only do they appear aesthetically unpleasant but the condition can also affect your overall body outline and self-confidence. The beauty ideals of the female breasts include perkiness, firmness, and shape. When these qualities of the breasts are lost, the patient experiences lower self-esteem. Saggy breasts make you look aged as well. Is there a ‘best’ breast lift technique available? Many women suffering from saggy breasts often wonder whether there exists something like the best breast lifting technique. The fact is that the breast lift technique best for one woman is not necessarily best for another one. What is best for you depends on your tissue characteristics, your breast width and size, the severity of the breast sagging, the distance between your nipple and breast crease, and the distance between your breasts. Most plastic surgeons are concentrated on only a single type of breast lifting and tell patients that their approach is the best one. Other surgeons rarely take measurements of the breast dimensions and recommend the surgical plan based on what they see visually. The visual findings can be a fallacy of the eyes. A good plastic surgeon will advise you a surgery technique based on quantifiable results found during the measurement of the breast dimension. Mastopexy incision options Mastopexy types are categorized on the basis of the types of incisions. Different incision types can be used to perform the operation. Each incision type treats different levels of sagging in the breasts. Below are the different incision options for mastopexy: Periareolar incision The periareolar technique involves very small incision compared to other methods. While this may seem attractive to you, this incision option comes with many tradeoffs. It is recommended only for patients who have minor sagginess in the breasts, particularly down pointing nipples. The incision is placed above the nipples but within the areola. If this incision type is used to treat moderate or severely saggy breasts, the results will not be satisfactory because it will lead to the development of puckered skin at the site of the incision. The periareolar incision is recommended for women who have nipples that are pointing downward. It does not involve removal of the excess skin from the breasts or tightening of the loose breast muscles. When a surgeon uses this incision technique, he will place a purse string suture under the skin so that the tension created on the incision is warded off. The best way to know whether this incision type is best for you is to consult with a board-certified plastic surgeon. However, you can benefit from this approach when you are a good candidate and your goals are reasonable. The good news is that you will get a less visible and smaller scar on the areola with this incision option. Also, the recovery period is shorter, and you can resume your daily activities a few days following the operation. Vertical incision As the name suggests, the incision is made around the areola, and another incision is placed vertically that goes down from the areola, which may result in more scarring. To avoid the excessive scarring, the plastic surgeon collects the skin in an upward direction and into the lower area of the breast. The skin in the fold is then removed. This incision option is recommended for patients who have moderately saggy breasts. If you are a good candidate for the vertical incision, you can get optimal and sustainable results with this option. This incision technique is also called lollipop lift because the resulting scars resemble the shape of a lollipop. This option is best for women who have large breasts that are moderately saggy. When this incision option is used for the right candidate, the breasts can be firmer and sensuous. When the vertical incision type is used, your breasts will appear rounder, perky, and cone-shaped. It gives a natural appearance to the breasts. The second incision made during the surgery fundamentally repositions the nipples, giving it a lively and youthful appearance. The second incision will be used if the nipple is pointing downward. The good news is that this incision type also allows the surgeon to remove the excess skin and fat from the breasts, besides tightening and repairing the loose breast muscles. As a result, you can expect to get all-encompassing outcomes. Mastopexy with the vertical incision is performed under general anesthesia. It is also an outpatient procedure. After a board-certified anesthesiologist administers the anesthesia, the plastic surgeon will start the operation by making the vertical incision. In the next step, the surgeon will access the separated breast muscles through the incision and then tighten them. Using the second incision, the surgeon will lift your loose nipples. He will then remove the excess skin from the breasts along with any excess fat and then suture and close the incisions. Inverted- T incision With this incision option, the surgeon gets maximum control over enhancing the breasts. It is recommended for patients with severely sagging breasts. It can correct breast sagging to a maximum level. The inverted T incision is also best for repositioning severely droopy nipples and expanded areoles. Furthermore, the risk of skin puckering at the site of incision is lower when this option is used, and the surgeon can remove the maximum skin from the breasts. On the other hand, this option involves the use of three incisions. The first incision is placed vertically down to the breast; the second is placed around the borders of the nipples, whereas the third incision is made on the breast fold. As a result of the three incisions, you will get more scarring on the breasts. The inverted T mastopexy is also performed under general anesthesia. After the incisions are made, the plastic surgeon can quickly tighten the loose breast muscles and remove the excess skin and fat from the breasts. It also involves raising of the nipples and reducing of the areola skin that may have expanded. After lifting the breasts and nipples, the surgeon will suture and close the incisions. Choosing your incision option Patients are not able to make a better decision about what incision option they should use. Ideally, you should consult with a board-certified plastic surgeon to know which incision option can help treat your breast sagging and achieve your aesthetic goals. The surgeon will examine your breasts and take precise measurements of your breast and other body features. The surgeon will also ask you as to what type of improvements you desire to achieve. Based on the findings made during the consultation, the surgeon will tell you whether you are a good candidate for a particular incision option. Conclusion Mastopexy is one of the commonly performed plastic surgery procedures in the US. It can effectively treat breast sagging. The best way to treat your breast sagging with mastopexy is by using the suitable incision option. There are three types of incision options that can be used to perform mastopexy. In this article, I have explained all three of them and the level of breast sagging each option can treat. All options come with pros and cons that have also been discussed above. To get satisfactory outcomes with mastopexy, you need to work with your plastic surgeon to select the right incision option for you.