What Is Mastopexy (Breast Lift)?
Greek μαστός mastos “breast” + -pēxiā “affix”
Mastopexy (breast lift) is a surgical procedure to raise and reshape a woman’s breast. The gravity of the Earth is the most common cause of breast ptosis, which is the prolapsation — the falling forward and the sagging — of the breast tissues from the woman’s chest.
- In the young woman with large breasts, the sagging occurs because of the volume and weight of a bust that is disproportionate to the woman’s body type, and because of the great elasticity of the thin, young skin envelope of each breast.
- In the middle-aged woman, breast ptosis is usually caused by the postpartum hormonal changes to the maternal body, which depleted the quantity of adipose fat tissue and atrophied the milk glands, and because of the inelasticity of the skin envelope, which was overstretched by the engorgement of lactation.
- In the post-menopausal woman, besides gravity, such breast ptosis atrophy is aggravated by the inelasticity of overstretched, aged skin.
“When I see women for mastopexy, for the most part, they have had children and they felt that their breasts have literally deflated and they’ve drooped. For a woman who is happy with the size of her bra, but doesn’t like the flatness at the top, mastopexy is the way to treat it.”
— Dr. Berkowitz
Should I Consider Breast Lift?
The usual mastopexy patient is the woman who desires the restoration of her bust (elevation and contour), because of the post-partum volume losses of fat and milk-gland tissues, and the occurrence of breast ptosis (sagging).
“With auto-implant mastopexy, I get fullness in the breast using the patient’s own tissues that many women want. They look like they have an implant, without actually having to resort to silicone.”
— Dr. Berkowitz
Consider mastopexy if you seek:
- To achieve fuller (not bigger) breasts
- To preserve your own breast tissue
- To avoid the risks and maintenance of breast implants (capsular contracture, shifting, implant monitoring and replacement)
The Procedure (as Described by Dr. Berkowitz)
The traditional operation for mastopexy was removing the excess skin and not really touching the breast tissue. This was a low-risk operation with an inverted “T” scar. It had a high failure rate because the breast tissue would continue to sink to the bottom, stretching out the remaining skin, and all you were left with was a higher nipple than you had, but then you really didn’t have anything to show for your scars. It was a very disappointing operation for the majority of women that had it done this way.
In the 1990s, surgeons in Europe, specifically Daniel Marchac and Madeline Lejour, determined that the majority of lift procedures could be done with a single incision. Instead of having an inverted “T,” it could all be done through a vertical seam (just taking out tissue in a vertical seam without having a horizontal scar). This doesn’t sound like a big change, but it really was, because it shaped the breast for the first time into a much more predictable shape with less of a scar.
In the late 1990s, Dr. Ruth Graf described taking the breast tissue and restacking it in origami fashion from a flat disk, or a pancake, and reshaping it into a mound with fullness in the top. That required separating the breast tissue. You must divide it into three parts: a central part, inner part and outer part (median and lateral). You take the lower part, the interior portion of the central part, and you bring it up to the top; and then you bring the median and lateral part over that, and it cones it. It narrows the diameter of the breast.
My unique contribution to this procedure is that I use a piece of biologic mesh to form a sling that holds the breast tissue up from the bottom and keeps it from sinking, like a hammock. It’s been extraordinarily successful.
For biologic mesh, we use either Strattice, which is a pigskin-derived biologic material, or SERI, a silk-based material from Allergan. (Learn more about biologic mesh at www.lifecell.com or www.allergan.com.)
The key to mastopexy is, what I call, Double Ds: diameter and distribution. You change the diameter from a wide, flat breast into a narrower-diameter, fuller breast using all of the patient’s own breast tissue. The operation takes about three hours, and has generally been quite successful.
Learn More about Breast Lift
For more information about breast lift surgery, please contact Dr. Berkowitz by calling (408) 559-7177.