Breast Uplift or Mastopexy is performed to improve the shape and position of the breasts.
This can be done for sagging breasts – which may occur with normal development and as a normal process of ageing. It can also occur with very large breasts as the weight of the breast pulls the breasts down with time. Pregnancy, breast-feeding, and weight also increase the droop, which is also called ‘ptosis’.
Mastopexy may maintain the original size of the breast moving the nipple to a higher position, and shaping the breast to lift the breast tissue into a suitable higher position.
Breast reduction surgery is different as it is used to reduce the breast size and lift the breasts at the same time.
If your breasts droop and have reduced in size, breast implants can be used to increase the size and the uplift performed to reposition the breast, all performed at the same time.
This is called Augmentation Mastopexy.
This procedure is used to correct drooping and loss of volume.
Loss of volume
This is corrected by inserting an implant under the breast tissue or under the chest muscle (pectoralis). The size of implant depends on the patient and is chosen by the patient to achieve the desired size. Augmentation alone may not be sufficient to raise the breast tissue into a higher position, especially where there is a considerable amount of excess or lax skin. This must be considered when deciding on breast enlargement surgery.
‘Ptosis’ is classified according to the position of the breast and nipple in relation to breast fold:
Grade 1: Breast is below fold, Nipple-areola at fold
Grade 2: Breast is below fold, Nipple-areola is also below fold
Grade 3: Nipple-areola pointing to the floor
Breast Uplift scars
Breast uplift surgery can be performed using two types of incisions.
Breast Uplift procedures re-shape the breast and modify the nipple-areolar position
These include the:
Anchor-shaped or inverted T-scar Lolly-pop scar from the areola to the breast crease
In addition to the skin scars, the breast tissue often needs to be surgically altered in shape.
It is important to have a realistic expectation of what can be achieved with breast uplift surgery. This is a challenging operation because of the unpredictable behaviour of pre-existing skin. As a result it is not uncommon to perform secondary procedures or adjustments.
Further surgery for adjustment is chargeable.
Frequently Asked Questions
Will the breasts start to sag again?
Gravity continues to have its effect, and there is a tendency for the skin of the breast to stretch over a long period of time. Women vary a great deal in this respect. If the skin is very lax and thin and stretched, it is unlikely to provide substantial support in the long term. Over a period of time the breasts are likely to drop again; this may be noticeable in the first 6 months or a few years later. In general, larger heavy breasts sag more, so a good supportive bra is always recommended. If the breasts sag further, revision may be necessary in the future. It is important to have realistic expectations.
It is very important to wear a good supportive bra especially in the day time when upright, and when exercising.
Are there any alternatives to surgery?
Using padded bras or bra inserts can make your breasts look larger with a better shape.
Natural breast enhancement pills that contain phytoestrogens (plant hormones that copy natural hormones) may help to increase the size of your breasts. However, these pills have not been fully tested and results are not predictable.
You can wear a well-supported under wired bra with to get the uplift effect and padding to increase the size.
What happens if I decide not to have the operation?
This is not a problem. Breast augmentation is not performed to improve your physical health. The choice to have cosmetic surgery is entirely yours.
What kind of breast implant should I choose?
There are many types and sizes of implants providing a wide range of choice. Implants may be silicone or saline filled. The latest technology suggests that textured implants reduce the risk of reaction and capsular formation. The silicone is manufactured into a cohesive gel such that damage to the implant does not cause liquid to spill. Cohesive gel retains its shape even if the implant ruptures.
The shape of the implant is “round” or “anatomical” which is tear drop shaped. The sizes vary and are chosen to fit your body and your preferences.
The choice of implants depends on chest width, height and forward projection. This is decided when you have a trial sizers and indicate your preferences.
Your surgeon will take measurements and discuss the options with you and recommend the most appropriate type and size for you.
There is also an option to have 3D simulation to visualise your breasts after surgery.
Are Breast Implants Safe?
Silicone is currently the most common and popular component used for breast implants. Silicone can be made into many forms and has brought major benefits to industries, such as food production and personal care products. Silicone is useful for healthcare products because it does not dissolve in water or react easily to changes in temperature or to substances in your body. Silicone is used to make heart-valve replacements, facial implants and tubes used to give people medication.
There is no evidence to suggest that women with silicone breast implants have a higher risk of developing autoimmune diseases or breast cancer or arthritis. There is a reported link between implants and a very rare type of cancer called anaplastic large cell lymphoma (ALCL); the risk is extremely small.
There is a small risk of capsular formation – this is a layer of tissue that forms around the implant, as a natural response of the body to the foreign material. If this layer becomes thickened it may contract and cause discomfort. This may require removal of implants and replacement with new ones. The incidence of capsular contracture is 1 to 5 % over 10 years.
Most implants come with a ‘lifetime warranty’. Some manufacturers offer to replace the implants free of charge in case of complications such as capsular contracture and rupture, (surgery is then chargeable). Some manufacturers will also contribute towards replacement surgery.
Complications of surgery
Unfortunately complications can occur following any surgery and patients need to know about these to make a fully informed decision.
The complications include:-
- Bleeding and haematoma formation and the need to return to surgery to stop bleeding
- Scarring may be thickened or raised
- Asymmetry of the breasts – small difference in breasts should be expected.
- Bruising, swelling, pain
- Numbness and / or alteration in nipple sensation
- Healing problems
- Implant palpability, visibility, rippling, capsular contracture, and skin rippling
- Difference in nipple size, shape, height
- Damage to the blood supply of the nipple-areolar complex, although uncommon, can occur and may result in partial or full nipple loss
- Blood clots in the legs (DVT) and lungs (PE)
If you have any questions, please do not hesitate to ask your surgeon or breast care nurse.