The medical term for breast sag is “ptosis”

Breast tissue tends to sag with increasing age- why?

  • More common after child birth and breast feeding
  • Hormonal influences
  • Gravity
  • The internal breast ligaments (Cooper’s ligaments) stretch
  • The skin stretches

What does a mastopexy involve?

  • Reshaping and lifting the breasts to produce a fuller, firmer bust
  • Reduction in the areola size if needed


Mastopexy Options

Depending on the severity of breast sag, different techniques are used:

  • Implants- only suitable for filling out minor sag
    • breast lift of 1-2cm achieved with full projecting implants
    • won’t prevent recurrent sag
  • Donut lift: scar around areola. Ok for minor sag only
  • Key hole lift: Combines the donut incision with removal of wedge of skin from between nipple and fold under breast
  • Wise pattern lift: For grade 2-3 sag. Anchor shaped scar (similar to the breast reduction)
  • Wise pattern mastopexy combined with Bra Lift

– This is a simple technique that was described by a personal colleague

– It involves a small additional procedure to create additional internal lift

– It may reduce recurrent ptosis


Understanding Breast Mastopexy

How is breast sag measured?

  • It is measured by the relation of the nipple position to the fold under your breast (the infra-mammary fold)

How is it graded?

There are three grades of increasing severity:

Grade 1 Nipple level with the crease


Grade 2: nipple < 3cm below crease


Grade 3: nipple > 3cm below crease


Is it Safe?

  • Breast Mastopexy takes between 1-3hrs depending on which method is used
  • Complications are not common but as for breast reduction may include:
    • Minor delays in healing
    • With the key -hole lift it can take a while for the vertical scar to flatten
    • Very rare: <1 in 1000: the nipple blood supply can be compromised causing tissue loss

Can it be combined with breast implants?

  • Yes, but there are additional risk if this is done at the time of the mastopexy
  • It is preferable to wait 12-months
  • If you are a smoker it is very important to completely abstain until properly healed.



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