Reshaping and repositioning the breast using the tissue that is already there.
Pregnancy, weight change, ageing and individual anatomy can alter the relationship between breast volume, skin and nipple position.
A breast lift—or mastopexy—reshapes the breast, removes excess skin and repositions the nipple and breast tissue to create a more balanced breast form.
Three elements determine the operative plan.
The position of the nipple and breast tissue on the chest determines how much repositioning is required.
The amount and quality of excess skin influence how much skin must be removed and which scar pattern is appropriate.
The amount and distribution of breast tissue determine whether the breast can be reshaped using its own volume or whether an additional procedure is useful.
The scar pattern follows from the amount of skin that needs to be removed. I use the shortest pattern that allows the breast to be shaped properly rather than compromising shape simply to avoid a necessary scar.
My preference where anatomy permits. The scar runs around the areola and vertically to the inframammary fold.
A short horizontal component can be added when needed to manage residual skin at the lower breast while retaining the advantages of a predominantly vertical pattern.
Where there is substantial skin excess, a full inverted-T or Wise-pattern approach may provide the control required to achieve the most appropriate breast shape.
The nipple and areola remain attached to living breast tissue—the pedicle—as they are repositioned.
I commonly use a superior or superomedial pedicle, selected according to the starting anatomy and the reshaping required.
Shorter scars are desirable, but not if they prevent adequate removal of excess skin or compromise the final shape.
The scar pattern is therefore a consequence of the operation required rather than the starting point for planning it.
A breast lift and breast augmentation solve different problems.
A mastopexy corrects position and skin excess. An implant adds volume. Some patients have enough existing breast tissue to achieve the desired result with mastopexy and internal reshaping alone.
Where additional volume is genuinely desired, augmentation can be combined with a lift. The implant should not, however, be used simply as a substitute for correcting significant breast descent.
Recovery depends on the extent of reshaping and whether mastopexy is combined with augmentation or another procedure.
Swelling, bruising and tightness are expected. Dressings and a supportive postoperative bra are generally used during early recovery.
Comfort and mobility progressively improve. Activity is increased gradually while heavy lifting and strenuous upper-body exercise remain restricted.
The breast shape settles progressively and scars mature over subsequent months. Some change in breast position with ageing, pregnancy and weight fluctuation remains normal over time.
The risks relevant to the proposed operation and individual anatomy are discussed carefully during consultation.
Consultation begins by assessing breast position, skin excess, existing volume and what you would like the breast to become. From there, we can determine how much reshaping is required, the scar pattern that allows it to be achieved reliably, and whether your own tissue provides the volume you want.
Arrange a consultation →Written and reviewed by Dr Constant van Schalkwyk, Specialist Plastic Surgeon ·
