All women have unique bodies and follow their own paths through life. This path may include pregnancy, breastfeeding, and weight gain or loss. All of these experiences as well as the natural aging process, influence how a woman’s body and breasts evolve over time. For women who are not happy with how their breasts have changed shape and are thinking about surgery to improve how they look and feel, a breast lift might be a good option.
Breast lift changes the shape and contour of the breasts rather than the size. The best surgical approach for each woman will depend on the size of her breasts, the condition of her skin and the amount of sagging she has experienced over the course of her life.
A good surgeon will listen to your vision for your body and discuss which techniques will give a result that suits your needs. Dr. Ginger Xu uses her technical expertise and artistic sense to make sure each client’s appearance will ultimately align with their own unique identity. Dr. Xu is a Board-certified plastic surgeon with specialty training in aesthetic plastic surgery at Harvard and is now based in the San Francisco Bay area.
A breast lift (also known as mastopexy) changes the shape and projection of the breasts rather than the size. This differs from breast augmentation or breast reduction, where the main aim is to change the size of the breasts, although an augmentation can be combined with a lift to better enhance the appearance of the breasts.
A breast lift is most commonly performed for women who have:
- Given birth
- Breastfed babies
- Lost a significant amount of weight
- Developed drooping breasts (ptosis) – this can occur with increasing age
Women might think about a breast lift after they have had a temporary increase in breast size. When breasts increase in size (eg. during pregnancy, breastfeeding or weight gain), the expanding breast stretches the skin. But once the breasts decrease in size, the skin remains stretched resulting in a deflated appearance and breasts that have lost some of their original fullness. The shape of the breast and position of the nipples can also change in a way that results in aesthetic dissatisfaction.
In general, a breast lift raises the nipple and areola, reconstructs or reshapes the breast tissue, and tightens the skin. A breast lift can give women:
- More self-confidence and improved self-esteem
- A more youthful appearance
- A breast shape that is closer to their appearance before pregnancy or weight gain
- A reduction in areola or nipple size
Women may want a breast lift for a range of reasons such as:
- Loss of fullness or firmness – breasts may appear deflated
- Breast drooping (ptosis)
- Excess or sagging breast skin, perhaps causing rubbing and irritation under the breast folds – this can occur with age or after giving birth, breastfeeding or weight loss
- Nipples that have descended from their original position – eg. they point downwards rather than forwards
- Nipple or breast asymmetry
Women can have one or a combination of these changes, which affect the overall appearance and contour of the breasts. Women are good candidates for breast surgery if they:
- Know why they want surgery to change the appearance of their breasts
- Have an idea of what they would like to achieve with their surgery
- Understand what the surgery involves
- Are non-smokers or have not smoked for six weeks or more – smoking affects wound healing and nipple viability
There are several possible techniques for a breast lift. Each technique has the potential to give different contours to the breast and different levels of scarring. Your surgeon can tell you about the best approach to suit your situation. For women with smaller breasts who do not need to have excess skin removed, a nipple lift alone might be enough to change the appearance.
During a consultation, Dr. Xu can recommend the best technique for you after she examines your skin and nipples and has a good understanding of your vision and goals. The options below appear in order from the least extensive to the most extensive surgical techniques.
Of note, each of these techniques also allows the possibility of combining a breast lift with a breast augmentation procedure at the same time.
A crescent breast lift (also known as a periareolar or partial breast lift) can be a good option for women who do not have large breasts and who do not have much sagging or drooping.
The surgeon makes a crescent-shaped incision around the top of the areola and then raises the nipple and breast to give a better contour. This technique helps to camouflage the scar along the border of the areola.
A circumareolar breast lift (also known as a “donut” lift or Benelli lift) can be a good option for women who have a slightly larger breast size, with a modest need for lifting the nipple position. Two circular incisions are made around the areola and these allow tightening of the breast skin to correct modest sagging. This technique helps to camouflage the scar along the border of the areola.
The vertical breast lift (also known as a lollipop lift) can correct a moderate amount of sag or droop for women with average breast size. The surgery results in two scars in a lollipop shape. One scar is around the areola and the second extends vertically from the areola to the crease under the breast.
This technique gives the surgeon more ability to reshape the tissue and improve the projection and contours of the breast. This breast lift is stable over time but does create a vertical scar that will fade with time.
An inverted-T breast lift is a common technique for women with larger breasts. The inverted-T lift is the most powerful option of all and allows the surgeon to remove more skin and can give a significant lift for women with larger breasts and significant drooping or sagging.
The surgery involves final scars in three locations that create an anchor shape – one around the areola, one extending vertically down to the breast crease, and one extending horizontally along the crease under the breast. This creates more potential for scarring but gives the surgeon maximum access to remove skin and fat tissue and reshape the breast.
Just as the skin on the breast stretches with weight gain and other life changes such as pregnancy, breastfeeding or natural aging, the areolas can also become larger. Your breast lift can also incorporate areola reduction surgery at the same time. This will decrease the size of the areola so it is in proportion with your breast shape after surgery and give you a more aesthetically pleasing result.
You and your surgeon must communicate and work together so you have a good understanding of the process that will give you the best results. The goal of a good surgeon should be to arm you with the knowledge to understand the factors affecting your breast lift.
Dr. Xu can discuss how your age, breast size, breast shape, and skin affects the choice of surgical technique and the results you can achieve.
It is important you have a realistic understanding of:
- How your breasts will look after surgery
- Where your nipples will be positioned
- The limitations of the surgery
- Any short- and long-term effects such as scarring
- Any possible complications
- The potential need for more breast surgery
The breasts are a very sensitive part of the female anatomy and women have different levels of scarring they can tolerate. Dr. Xu can explain which technique she would recommend for your situation and the level of scarring you can expect.
Techniques causing more scarring might also give you a breast shape closer to your goals. Dr. Xu can give you the information you need to weigh the benefit of more aesthetically-pleasing breast shape with the level of scarring.
Dr. Xu encourages open and honest communication about your body, your lifestyle and what you want for the future. Photos of your desired look can help her understand your needs. Your medical history is also important, including any information about pregnancies, breastfeeding, weight loss, breast cancer or other medical conditions.
Things to also discuss with Dr. Xu include:
- Why you want the surgery
- Your future lifestyle goals
- What appearance you hope to achieve
- What sort of breast shape or form you would like
Many women wonder whether they need a breast lift, breast augmentation or both. It is important to know that some surgeons might recommend augmentation with breast implants when a breast lift or combined surgery would have been a better option.
Augmentation alone is an easier technique than a breast lift or combination surgery, but will not always give the desired results. It is important to choose a good surgeon with the experience and artistic sense to work with you to achieve realistic goals as close as possible to your vision for your body.
Two situations where a combined breast lift and augmentation might be recommended are:
- After pregnancy, breastfeeding, weight loss, or natural aging, the breast can appear deflated and there may be excess sagging skin. If a woman would like her upper breast to look fuller, especially in the upper pole, combining a breast lift with breast augmentation can be a good option.
- If there is insufficient breast tissue for the surgeon to reconstruct an aesthetic shape to the breast, a breast implant can add fullness to the breast.
When a breast lift is combined with breast augmentation, there can be a higher chance of complications relating to the implant and wound. There are competing forces on the breast skin – one procedure tightens the skin, whereas the other expands the skin. It is especially important in these scenarios to choose a surgeon who will set realistic goals with you, execute safe surgery, and make judicious decisions while in the operating room.
After pregnancy or significant weight loss, women might want breast surgery and surgery to their abdominal area otherwise known as a “tummy tuck“. These two surgical procedures are the foundation of surgery for women after pregnancy (mommy makeover), but can also be suitable for women who have had significant weight loss.
Both pregnancy and weight loss affect the abdominal area as well as the breasts and can leave women with excess sagging skin and stretch marks on the abdomen.
A breast lift (and/or breast augmentation or reduction) can be performed at the same time as a tummy tuck. But there can be competing forces due to the pull of the torso skin in different directions, and this must be considered during this type of surgery. When combining surgeries, it is important to find a surgeon with experience in complex techniques of cosmetic plastic surgery. Dr. Xu is a Board-certified plastic surgeon who has trained extensively, including completing an Aesthetic Plastic Surgery Fellowship at Harvard.
In addition to a breast lift, some women would like to improve their overall look with additional body contouring around their chest and torso. Dr. Xu will examine your entire body with an artistic eye and let you know if liposuction can enhance your results. Areas that can be shaped and contoured with liposuction during a breast lift include the:
- The outer region of the breast – liposuction on “bra side rolls” can improve the contour of the whole breast and chest area
- Armpit – liposuction of armpit fat (also known as an “axillary roll”)
- Back – liposuction of fat from back rolls
- Abdomen – liposuction in this area can be done alone or as part of a tummy tuck or mommy makeover
Age is one of the factors that can influence when and how you have breast lift surgery. If you have any concerns about your age or other factors affecting your surgery, Dr. Xu can discuss all the risks and benefits with you.
Younger women need to think about their future before committing to a breast lift. If you think you might want a family in the future, understand that your breast size will change with pregnancy, breastfeeding, weight gain or weight loss. In this case, you might want to consider delaying your breast lift and waiting until your skin has settled down after pregnancy, breastfeeding or weight loss.
Younger women might also want to consider the function of the breast after surgery – especially the ability to breastfeed and nipple sensation. During a breast lift, the surgeon will shape the breast tissue while aiming to maintain the structures of the breast such as milk ducts, blood vessels, and nerves. The amount of function remaining after surgery also depends on the technique used for your breast lift.
Most women can breastfeed after a breast lift, but you may not produce as much milk. Some women can’t breastfeed even without breast surgery. It is important to understand that if you can’t breastfeed, you will have to use formula to feed your baby. If you are concerned, you might want to wait and have a breast lift after you have finished breastfeeding.
The circumareola or peri-areolar breast lifts (see above: “Breast Lift Options and Techniques”) are less likely to have an impact on nipple sensation. If breast sensation is decreased, most women slowly regain sensation in their nipples with time. It can take up to a year for full sensation to return. In some rare cases, women permanently lose sensation in their nipples.
As age increases, women need to think about a number of factors that can impact their breast lift. These include:
- Sagging or drooping of the breasts increases with age
- A more extensive breast lift procedure with more extensive incisions might be needed
- More extensive surgery creates more scarring
- Wound healing capacity is weaker with age
- The skin may be thinner or weaker
- The body takes longer to recover
All women have differently shaped bodies and skin types and have had different life experiences. Dr. Xu has extensive aesthetic plastic surgery experience and can discuss options to best suit your body type, your vision for the future, and your personal history. There are a number of surgical options if you have experienced significant weight gain and loss. The potential effects of significant weight loss include:
- A higher risk of wound healing problems
- A need to combine a breast lift with augmentation to improve upper breast fullness
- Significant excess skin needing more “bunching” along the incisions or longer scars to gather excess skin
- Thinner and stretched skin affecting the available surgical approaches
- The additional need for an upper-body lift or body contouring to give optimal overall aesthetic results
Dr. Xu understands the responsibility of transforming a woman’s appearance to better reflect their identity and build self-esteem. Her top priority is understanding your vision and desires.
Once Dr. Xu has examined your body, breasts, and chest, she will use her artistic sense and technical expertise to recommend an approach to your surgery that will best suit your goals.
During a consultation, Dr. Xu will explain:
- The different types of breast lift options
- Which breast surgery options would best suit your needs – and whether you might also benefit from breast augmentation or reduction
- What types of incisions will be needed
- How much scarring you can expect
- How other surgeries (eg. breast augmentation, liposuction tummy tuck, mommy makeover) can fulfill your vision for your body
- Any need for further operations
- Potential complications or side effects
Once you and Dr. Xu have agreed on a surgical approach, Dr. Xu will book your surgery time and give you instructions on what to do before and after surgery.
Dr. Xu will also let you know which medications you should and should not take prior to your surgery and what to do on the day of your surgery. It is important to stop smoking at least 6 weeks prior to surgery.
You may need to get a blood test or undergo additional workup depending on your medical history. Dr. Xu may also correspond with your primary care doctor to ensure you are in an optimal state of health prior to surgery.
In the weeks before surgery, recommendations to help you prepare include:
- Make sure you get enough sleep and rest
- Eat a healthy diet with adequate protein and nutrition
- Exercise or engage in physical activity to strengthen your body
- Maintain a positive state of mind
- Prioritize your well-being and reduce stress levels
It is essential that you feel comfortable about your upcoming procedure and fully understand the process. Dr. Xu encourages her patients to ask any questions about their surgery or their recovery.
After your breast lift surgery, you will feel mild to moderate discomfort. The amount of pain you feel depends on a number of factors such as:
- The type of breast lift surgery technique used
- Whether you have had other surgeries completed at the same time (eg. tummy tuck)
- Your age
- Your health before the surgery
Prescription pain medications might be needed for the first few days. After this time, any pain should be relieved with over-the-counter or non-opioid medications.
Recovery typically takes approximately two weeks. During this time, you should avoid lifting anything heavy. Once bruising and tenderness have gone, you can return to normal activities. Most women can return to work after a week, but strenuous exercise should be avoided for four to six weeks. Ask your surgeon when you can return to the full range of activities.
If you have had a combination of surgeries, Dr. Xu can advise you of any additional recovery needs.
Dr. Xu believes in focusing on understanding each woman’s goals and respecting their personal history, anatomy, and vision for the future. Her combination of surgical expertise and sense of artistry can optimize your results by:
- Recommending the correct surgery – Dr. Xu will take into account your anatomy and the condition of your skin and breasts and let you know if breast augmentation or breast reduction might better achieve your goals
- Decreasing the risk of scar spreading or thickening – Dr Xu will make sure that the wound closure is not too tight or too loose and that there is a good balance of skin to breast volume
- Taking steps to minimize anesthesia time during surgery as well as swelling, pain, and scarring after surgery
If you would like to know more, contact our San Francisco office to schedule a consultation.
Before you commit to breast lift surgery, a good surgeon will make sure you understand and accept all the implications of the surgery. This includes the potential for scarring. Dr Xu will explain what will affect the amount of scarring you will experience including:
- The type of breast lift surgery
- The tightness of the skin closure
- The condition of your skin – thin or stretched skin or a lot of excess skin
- Your skin type – some people are born with skin that scars more easily
Dr. Xu uses surgical techniques to decrease the risk of scars spreading or thickening. Scars never disappear but they will fade and become less obvious with time.
After your breast lift surgery, the shape of your breasts will “settle” over the first six weeks. Some women might also have minor changes after six months but the overall shape of your breasts should be stable for many years.
With time, your skin will continue to age normally and your breasts will continue to change naturally. Many women consider this an acceptable part of aging and do not wish for more surgery. Dr. Xu recommends follow up over time to make sure your breasts are in good shape and if you are thinking about more surgery, she can give you appropriate advice.
After breast lift surgery, you will feel mild to moderate discomfort. The amount of pain you feel depends on the type of surgery you had, your age and your overall health. Prescription pain medications might be needed for the first few days. After this time, any pain should be relieved with over-the-counter or non-opioid medications.
Most women can breastfeed after a breast lift, but you may not produce as much milk. If you can’t produce enough or any milk, you will have to use formula to feed your baby. If you are concerned, you might want to wait and have a breast lift after you have finished breastfeeding.
Some breast lift techniques are less likely to impact nipple sensation. If sensation is decreased after a breast lift, most women slowly regain sensation in their nipples with time. It can take up to a year for full sensation to return. In rare cases, women permanently lose sensation in their nipples.
The position of scars depends on the type of breast lift surgery you choose. In some breast lifts, the scar will be camouflaged along the border of the areola. Other techniques have the potential to give you better breast shaping and projection but will produce more obvious scars. In all types of breast lift, a bra or swimsuit will hide any scars.
Scars will initially appear red or pink and slightly raised up until 6 weeks when they begin to remodel and become less noticeable over time. Scars will heal at different rates (up to 18 months) depending on your age, skin type, skin tone and exposure to the sun. Ultimately, scars will fade but do not disappear.
After the standard recovery time of four to six weeks, a swimsuit with a bikini top may irritate if you have scars under the breast. Underwires can irritate healing scars and should be avoided until your scar is not tender to the touch. Sun and water exposure should also be avoided while your scar is healing. Ask your surgeon when you can safely wear a swimsuit and enter the water.