Breasts come in many different sizes and shapes. Some are naturally attractive, perfectly shaped and symmetric. Others are not so perfect. For some women, breast development begins with oblong shapes and downward gazing nipples. In others, what began well, changes due to the effect of weight change, pregnancy, breast-feeding, or aging. If volume is the only concern, breast augmentation may be enough. But when the breast shape is the issue, mastopexy may be the best solution.
Mastopexy is the general term to describe the surgical revision of the breast to make it more attractive. It usually includes repositioning the nipple areolar complex to a more appealing location, often reducing the areolar size, and tightening the breast’s skin. It can be performed on both breasts, or only one to create symmetry. It may involve enlargement with a breast implant or it may involve a small reduction in volume and size.
There are many techniques used in mastopexy. They are usually described by the location of their scars. The most common types are circum-areolar, vertical, and anchor.
The circum-areolar technique places the scar only around the areola. Variations of this include, crescent lifts, concentric lifts, Binelli lifts, and donut mastopexy. The idea is to only put the scar at the edge of the areola. They work very well in the right patients. The best results occur in cases where the movement of the nipple areolar complex is slight.
The vertical mastopexy is also called the circum-vertical mastopexy and the lollipop mastopexy. The nipple areolar complex is lifted on the breast mound and excess skin is removed along the line from the areola to the lowest part of the breast. This limits the scarring somewhat but often provides a better appearance to the nipple areolar complex. This is the most popular technique advocated today and gives a good shape while limiting scars.
The anchor lift, also called the pattern of Wise, involves scarring around the areola, going down the breast like the vertical, and also a scar along the base of the breast. The advantage of this technique is the control of the final shape. The disadvantage of the anchor lift is the scarring. It is however very appropriate in large breasts or in cases of very loose skin where a less aggressive technique would provide poor results.
Mastopexy can also be performed with only low scars, lateral scars, or scars only around the areola and the base of the breasts.
The American Society of Plastic Surgeons reports that in 2012, 89,000 breast lifts were performed. Though not as frequent as breast augmentation, this number reflects the growing acceptance of this operation to correct breast shape.
The first questions are quite simple; what do we have and what do we want? No two patients are exactly alike, so no operations are exactly alike. Mastopexy can be a very complex operation. If you combine augmentation, skin tightening, and nipple repositioning at one sitting, you have to understand what each set of decisions mean to each part of the operation. Rarely, it’s necessary to stage the operation, doing the mastopexy and then performing the augmentation. Patients also have their own unique set of risk factors. Putting all the factors together for each operation can be challenging, but it is uniquely rewarding. With Dr. Geldner’s superior skill, 25 years of experience, and his experienced and compassionate staff, we exceed our patient’s expectations.
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“Dr. Geldner is an artist! Dr. Geldner did an amazing job. I had horrible distortion of my breasts and he did a lift with implants and I am thrilled. His entire staff was fabulous. Truly a concierge practice! The best!”