Breast sagging (ptosis) is a common problem following pregnancies, weight loss or aging. Sagging occurs when breast skin stretches, and breast tissue and fat degenerate over time. This results in a less youthful appearance of the breasts. Breast sagging can be corrected with a breast lift (mastopexy). If the breast sagging is minimal and the breasts are small, ptosis can be corrected with augmentation mammoplasty. This method causes fewer scars on the breast than mastopexy. The mastopexy procedure may be performed under either local anesthesia with intravenous sedation or general anesthesia. The operation takes about two hours, and patients often return home the same day. During mastopexy, surgeons reposition the nipple and areola to a higher position and remove excess skin from beneath the breast. Closing the remaining skin lifts the breast mound to a higher position and recontours the breast to give it a more projected and youthful appearance.
If there is inadequate breast tissue to fill the skin and achieve the desired size, a saline–filled breast implant may be placed beneath the breast at the same time, achieving both the desired size, shape and projection. Patients may resume limited activities the day after surgery and normal activities in three to four weeks. Pain usually can be controlled with oral pain medication. Sutures are removed one to two weeks after surgery. When there is marked sagging, the incisions required and resulting scars are similar to those resulting from a breast reduction. In cases of less breast sagging, mastopexy can often be accomplished with smaller scars.
Potential complications of mastopexy include bleeding, infection and healing problems. Patients may experience some decrease in sensation in the nipple. In addition, some patients may notice minor irregularities in the size and shape of the breasts, and in the position of the areola and nipple. Occasionally, infection or healing problems can cause scars to widen and a portion of the nipple and areola to be lost. On rare occasions, scars may become thick and red and require revision. Following mastopexy, patients may be able to breast–feed because the nipple usually is not separated from the milk glands. If an implant is used, however, problems with the implant can occur. Following the surgery and healing period, the breast will have a more attractive and youthful appearance. With time, however, there may be further sagging that could necessitate a revisional procedure.