Breast Lift (Mastopexy)

• What Is Breast Lift Surgery?
• Breast Lift Candidates
• Breast Lift with Implants
• Is a Non-Surgical Breast Lift Possible?
• Breast Lift Consultation
• Preparing for Beast Lift Surgery
• Location of Your Breast Lift Procedure
• Anesthesia for Breast Lift Surgery
• Breast Lift Procedure
• Breast Lifting Risks
• After Breast Lift Surgery
• Breast Lift Recovery
• Breast Lift Results
• Breast Lift Scars
• Breastfeeding After a Breast Lift
• Breast Lift Cost

Many women notice that over time their breasts begin to lose their youthful shape and position. Pregnancy, breastfeeding, weight changes, aging, and genetics can all contribute to stretched skin, reduced volume, and sagging. These changes can make the breasts appear deflated or lower on the chest than they once were.

Breast lift surgery is designed to restore a more youthful, balanced breast contour. At Richmond Aesthetic Surgery, Dr. Neil J. Zemmel works with patients who want to lift and reshape their breasts for a firmer, more rejuvenated appearance. Some women simply want to elevate the breasts without increasing their size, while others choose to combine a breast lift with implants to enhance both shape and fullness.

By tightening excess skin and repositioning the breast tissue and nipple to a higher position, a breast lift can help patients feel more comfortable in their clothing and more confident in their overall figure.

What Is Breast Lift Surgery?

Breast lift surgery (mastopexy) is designed to lift and reshape the breasts by tightening excess skin, repositioning the breast tissue, and raising the nipple and areola to a more youthful position. The specific technique used depends on the size and shape of the breasts, the quality of the skin, and the amount of lift required.

Dr. Neil J. Zemmel performs several breast lift techniques to help patients achieve natural-looking, balanced results. In some cases, a breast lift may also be combined with breast implants to restore lost volume while improving breast shape.

Am I a Candidate for Breast Lift Surgery?

Breast lift surgery is often sought by women after pregnancy, breastfeeding, or significant weight loss, which can leave the breasts with stretched skin and reduced volume. These changes may cause the breasts to appear deflated or sit lower on the chest. A breast lift tightens excess skin, reshapes the breast tissue, and raises the nipple and areola to create a more youthful breast position and contour. Dr. Zemmel offers breast lift surgery for women with many different breast sizes and shapes. Breast lift surgery may be a good option for women who experience:

• Sagging or drooping breasts
• Stretched skin after pregnancy or breastfeeding
• A deflated breast appearance after weight loss
• Nipples that sit lower on the breast or point downward
• A desire to restore a more youthful breast shape without significantly increasing breast size

In some cases, women with smaller breasts who are primarily concerned about lost volume may benefit from breast implants alone rather than a lift. During your consultation, your surgeon will evaluate your anatomy and goals to recommend the most appropriate treatment plan.

Breast lift surgery may also be appropriate for younger women whose breasts have lost shape due to pregnancy or significant weight loss. Patients with realistic expectations about the procedure are typically the most satisfied with their results. While larger breasts can certainly be lifted and reshaped, the results may not last as long due to the natural effects of gravity and tissue weight.

Patients should also be aware that future pregnancies can affect the results of breast lift surgery, and in some cases an additional procedure may be desired later.

The best candidates for a breast lift are women who are in good overall health and do not smoke. Because smoking can interfere with healing, Dr. Zemmel requires patients who smoke to stop at least six weeks before surgery and for six weeks after surgery to reduce the risk of complications and support proper recovery.

Do I Need a Breast Lift with Implants?

Many women who are good candidates for breast lift surgery have very little breast or fatty tissue within the breast itself. In these cases, a breast implant may be recommended along with the lift to restore volume and provide better overall shape. The implant not only adds fullness, but can also serve as a foundation that helps support the breast and improve long-term results. Dr. Zemmel believes that for some patients, combining a breast lift with implants can produce a more balanced and longer-lasting outcome than a breast lift alone.

A breast lift with implants is often chosen by women who have lost breast volume due to pregnancy, breastfeeding, or significant weight changes. By combining breast lift surgery with breast augmentation, the breasts can be lifted, reshaped, and restored to a fuller, more youthful appearance. This combination procedure may also be performed as part of a more comprehensive mommy makeover, along with procedures such as tummy tuck surgery.

Is a Breast Lift Without Surgery Possible?

Before considering breast lift surgery, many women explore non-surgical ways to lift or firm their breasts. Unfortunately, most non-surgical options only address the skin and provide little to no meaningful lifting. Breast sagging is typically caused by stretched ligaments and weakened supporting tissue, which cannot be corrected with creams, devices, or other non-surgical treatments.

Some people also believe that strengthening the chest muscles through exercise can lift the breasts. While exercise can improve muscle tone beneath the breasts and may create a slight lifting effect in some individuals with smaller breasts, it cannot tighten loose skin or restore stretched breast tissue.

Although non-surgical cosmetic treatments continue to advance, surgery remains the most effective way to correct sagging breasts. During breast lift surgery, excess skin can be removed and the underlying tissue tightened to raise the breasts to a more youthful position and create a natural-looking result.

What Does the Breast Lift Consultation Involve?

During your consultation, you and your surgeon will discuss your goals and expectations for breast lift surgery. Dr. Zemmel takes the time to understand what you would like to achieve so he can recommend a treatment plan tailored to your needs.

Your complete medical and surgical history will be reviewed, including any medications you take, allergies, and whether you smoke. You will also be asked about your most recent mammogram (if applicable) and whether you or any close family members have had breast-related conditions. A full breast examination will then be performed, focusing on factors that are important when planning a breast lift procedure, such as:

1. The overall size and shape of your breasts
2. The quality of your skin and the presence of stretch marks
3. The amount, quality, and distribution of breast and fatty tissue
4. The shape and symmetry of your breast bone and rib cage
5. The size, shape, and location of your nipple and areola
6. The size, location, and symmetry of the crease beneath your breasts
7. The proportions of your upper and lower body
8. Your height, weight, and cup size
9. The presence of any cysts, lumps, or masses

Dr. Zemmel will also review where you would like the breasts and nipples to be positioned and explain the breast lift techniques that may be used to achieve your desired results. Important details of the procedure will be discussed as well, including anesthesia, incision locations, expected scarring, and the recovery process.

This is also an opportunity to ask questions and make sure you feel fully informed and comfortable before moving forward. While no surgery can permanently delay the effects of gravity, mastopexy can “set back the clock” giving a long-lasting result.

How Should I Prepare for Breast Lift Surgery?

Once your surgery is scheduled, you will receive detailed instructions on how to prepare for your breast lift procedure. These guidelines are designed to help ensure a safe surgery and smooth recovery.

Depending on your age and family history, you may be required to have a mammogram (breast x-ray) before surgery. Our surgeon typically requests mammograms for women over the age of 40. You may also need routine blood work prior to your procedure.

You will be given specific pre-operative instructions, including guidelines on eating and drinking, smoking, and taking or avoiding certain medications and vitamins before surgery. Following these instructions carefully can help reduce the risk of complications and support proper healing.

While preparing for surgery, it is also important to arrange for someone to drive you home afterward and assist you for a few days during the early recovery period.

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Where Will My Breast Lift Procedure Be Performed?

Your breast lift surgery will be performed by Dr. Zemmel at either Bon Secours St. Francis Hospital in Midlothian, Virginia, or in Bon Secours St. Mary’s Hospital in Richmond. He performs all of his surgeries in the hospital setting. He believes this gives patients the highest level of patient safety and improves outcomes. Dr. Zemmel has the full resources of the hospital available if needed. The operating rooms at both St. Francis and St. Mary’s are certified by The Joint Commission and, therefore, meet the highest level of safety standards.

Breast lift surgery with or without an implant is typically performed on an outpatient basis. If you are undergoing a combination of procedures, such as a tummy tuck or liposuction with your breast lift, then our surgeon usually requires you to spend the night in the hospital.

What Type of Anesthesia Will I Have for Breast Lift Surgery?

Dr. Zemmel performs breast lift surgery under deep sedation or general anesthesia. The type of anesthesia used is usually determined by the anesthesia provider. Regardless of the type of anesthesia, you will be completely asleep during surgery, comfortable and totally unaware of the surgery. After surgery you will be transferred to the recovery room for 1 to 2 hours. There you will be made comfortable by the nurses and prepared for your discharge home.

How Is the Breast Lift Procedure Performed?

Mastopexy is typically performed in one to two hours, depending on the technique used. If breast implants are placed, an additional 45 minutes are needed.

Dr. Zemmel uses four different techniques, depending on the power of the lift required. A smaller amount of excess skin and a nipple/areola placed relatively higher on the breast will require a smaller lift. For those women with a significant amount of excess skin and nipple areola that is placed lower on the breast, a full lift may be needed. The appropriate technique will be determined prior to surgery based on what will give you the best overall shape and contour. The incision pattern dictates how much excess skin will be removed and allows your surgeon access to the deeper tissue of the breast for reshaping.

The types of lifts are as follows:

1. Crescent Breast Lift: Those who need minimal lifting of the areola may be the best candidates for a crescent mastopexy. This technique removes a small, moon-shaped section of skin above the areola. When this is closed, the areola is subsequently moved higher on the breast. This type of lift utilizes a small incision at the top border of the areola that is well-disguised and heals well.
2. Periareolar Breast Lift: This is also referred to as a doughnut mastopexy, concentric mastopexy, or Benelli Mastopexy. Dr. Zemmel performs this technique with the addition of an implant. The periareolar mastopexy can effectively tighten loose skin while reducing the areolar size. It is carried out as a circular incision is created around the border of the areola. A doughnut-shaped area of skin is then removed and the incision is closed, hiding potential scarring around the border of the areola.
   
3. Vertical Breast Lift: A vertical mastopexy, or full-anchor pattern incision, is ideal for those who have a greater amount of excess skin and sagging than can be properly addressed with the above techniques. This procedure involves an incision that completely traces the areolar border and includes a vertical, downward incision, creating a “lollipop” shape. The anchor pattern may also require a horizontal incision in the inframammary crease below the breast.
   
4. Full Mastopexy: A full mastopexy is recommended when the amount of excess skin and the areola position cannot be effectively lifted utilizing a different technique. With a full lift, the incision is made around the areola, vertically above the areola, and within the breast’s natural fold. This “anchor” pattern has the shape of an upside down “T.” Although it utilizes the largest incision, scarring is well-concealed and tends to heal nicely. In our surgeon’s experience, patients will always accept a full lift incision pattern for the benefit of improved shape.
   

As a general principle in breast lifting, the more excess skin present and the lower the nipple–areola sits on the breast, the more extensive the lift required to achieve an attractive shape. Our surgeon believes that most patients are willing to accept a somewhat longer scar in exchange for a significantly improved breast contour.

If a breast implant is placed along with your breast lift, the same incision can typically be used. The implant may be positioned in a pocket either directly beneath the breast tissue or deeper under the chest muscle.

Dr. Zemmel closes all incisions with fine absorbable sutures that produce an excellent cosmetic result and do not need to be removed. During your consultation, he will carefully review which technique is most appropriate for you and explain the advantages and limitations of each option.

What Are the Risks of Breast Lift Surgery?

A breast lift is a complex breast operation that should be performed by a qualified plastic surgeon. While the magnitude of a breast lift surgery is less than a cardiac or abdominal operation, for example, breast lifting has risks that must be addressed. Your surgeon will do everything in their power to provide you with the safest, most reliable procedure with the best outcome. This is accomplished through a number of ways:

1. Performs all surgery in the hospital setting and uses only operating rooms with the highest level of safety accreditation.
2. Performs surgery with board-certified anesthesiologists and board-certified nurse anesthetists to ensure the safest anesthesia.
3. Performs surgery with the same operating room team in order to maintain consistency with each procedure.
4. Uses the highest-quality materials and instruments when performing your procedure.
5. Follows his patients very closely after surgery to ensure the smoothest and easiest recovery for their patients.

With any surgery, however, there is always a small possibility of complications or a reaction to the anesthesia. Bleeding and infection following a breast lift are extremely uncommon and occur less than 1% of the time. Your incisions can widen to form thickened scars or you may have some asymmetry between the bests. You can reduce your risks by closely following your surgeon’s advice before surgery and post-operatively. They will discuss all of the risks and potential complications during your initial and pre-operative appointments.

In rare instances, some patients may permanently lose feeling in their breasts after surgery. However, when performed by a skilled and experienced plastic surgeon, there is very little chance that complications will arise during or after breast lift surgery.

Dr. Zemmel is board-certified by the American Board of Plastic Surgery and performs breast lift surgery in fully accredited operating rooms with an accredited anesthesia team. Dr. Zemmel and his team take every precaution to ensure that cosmetic procedures at Richmond Aesthetic Surgery are completely safe.

What Can I Expect After Breast Lift Surgery?

After surgery you will be transferred to the recovery unit until you fully awaken and are made comfortable. From there you will be transferred back to your room in pre-operative holding, and discharged home. If you have undergone a combination procedure such as a “Mommy Makeover” you will be transferred to your room on the surgical floor.

You will awaken from surgery wearing a soft surgical bra similar to a sports bra. You should wear this for several weeks after surgery. You can expect to see your surgeon one to three days after surgery for your first post-operative appointment. During this visit, you will be given instructions before hospital discharge detailing how to care for your bandages, your pain medicine regimen, when to shower, and your activity level. You will receive an instruction packet at your pre-operative visit and your surgeon will go over these in person before discharge.

Expect your breasts to feel tight, swollen and slightly bruised. Many patients report that having a breast lift feels like having their breasts engorged with milk during breastfeeding. The discomfort should be very tolerable and easily controlled with analgesics prescribed by your surgeon. The discomfort usually begins to resolve 3 to 5 days after surgery. At the first post-operative office visit, your bandages and surgical bra will be replaced by a soft sports bra. Depending on your progress, your surgeon will slowly increase your activity level over the next few weeks.

You will be seen frequently after surgery. Your first appointment after surgery usually occurs within 1 to 3 days. You will then see your plastic surgeon and their team every 5 to 7 days for approximately one month to closely monitor your progress.

At no time during your recovery should you feel “alone.” Dr. Zemmel and his team are always available to see you in the office or speak with you by phone to address any issues and concerns. Dr. Zemmel believes that meticulous post-operative care of their patients significantly improves outcomes and patient satisfaction.

Your surgeon will call you the night of your procedure to make sure that everything is okay.

What Does the Breast Lift Recovery Entail?

Healing from any surgical procedure is a gradual process and every one of Dr. Zemmel’s patients progresses at a slightly different rate. For smaller breast lifts, such as a crescent breast lift or a periareolar breast lift, the recovery time may be a few days. A full breast lift with breast implants may require 8 to 12 days for recovery.

Your surgeon will be there every step of the way to guide you through the recovery process. They will monitor your pain levels and assess the progress of any swelling or post-operative bruising. As your post-operative discomfort resolves and your incisions heal, your activity level can gradually be increased. In general most patients are able to return to work within 3 to 5 days for a smaller breast enhancement procedure, while the larger procedures may require 5 to 7 days.

You will be recommended to temporarily discontinue any heavy exercise or physical activity for several weeks after surgery. Our surgeon will usually allow light cardio activity 2 weeks after surgery, full cardio activity 3 weeks after surgery, and light weights 4 weeks after surgery.

When Will I See My Breast Lift Results?

The healing process takes anywhere from 6 to 18 months to complete. During this time you will notice an evolution of your results. Your scars should soften, fade, and blend into the natural contours of your breasts. They should gradually become less obvious, and most of the time they eventually fade to thin white lines. The scars can usually be placed so that you can wear even low-cut tops without showing evidence of your procedure. Your breasts will soften and appear more natural. Your results should last for many years, allowing you to enjoy your new look for the rest of your life.

Although breast lift surgery can significantly improve sagging (ptosis), it is not a permanent solution. Depending on your skin quality, lifestyle, and breast size, you will most likely experience some degree of sagging again in the future.

What Will My Breast Lift Scars Look Like?

The scars of all breast lifts (periareolar, vertical, and full mastopexy) heal very well. Our board-certified plastic surgeon will make every effort to minimize scarring with accurate technique in surgery as well as meticulous post-operative care. Approximately 2 weeks after surgery, patients will be placed on a scar treatment regimen. At the 6- to 12-month mark after surgery, many patients have very light, soft scars that blend into the surrounding breast contours. The scars are generally very well tolerated by most women and are hidden under clothing and bikini tops.

The location and shape of the scars will depend upon which breast lift technique is chosen. Whenever possible, incisions are hidden along the outer edge of the areolae. In cases when additional incisions are required to achieve the desired result, these incisions are placed so that they can be easily covered with a bra or bikini top. Some patients may also benefit from an incision concealed along the natural crease beneath the breast. 

At the end of your consultation, your surgeon will tell you where you can expect to see some scarring based upon your personalized surgical plan. The visibility of any scars should continue to diminish over time.

Will a Breast Lift Affect My Ability to Breastfeed?

Breast lift surgery typically does not affect a woman’s ability to breastfeed. If you are able to breastfeed prior to surgery, you should also be able to after your procedure. With this in mind, some women are unable to breastfeed whether they have had breast surgery or not. 

While Dr. Zemmel usually recommends that patients wait until after having children to undergo breast lift surgery, since pregnancy and breastfeeding can compromise their results, make sure to let him know if you plan to have children and nurse in the future. This allows him to plan the surgical technique to minimize any risks that may affect your ability to breastfeed.

How Much Does a Breast Lift Cost?

Breast lift surgery typically costs approximately $8,000-$9,500 at Richmond Aesthetic Surgery. This estimate includes the surgeon’s fee, anesthesia used, surgical facility, and other related fees. The expertise of the plastic surgeon, geographic location of the practice, and type of breast lift performed will all influence the total cost of your procedure. Although most insurance plans do not cover breast lift surgery, our team offers plastic surgery financing to help make your total cost more manageable by breaking it into smaller, monthly payments. If you are interested in taking advantage of our financing options, a member of our staff would be happy to help you get started.

Additional factors that may influence the final price include whether an implant is used to increase breast volume, the overall complexity of the procedure, post-operative compression garments, and routine post-operative visits. Your surgeon can provide you with a quote for breast lift surgery at the end of your preliminary consultation. Qualifying patients may benefit from flexible payment plans, low monthly installments, and low interest rates through financing.

Schedule Your Breast Lift Consultation

For more information on breast lift surgery, or to schedule a consultation to talk more about how this procedure can help you attain your goals, please contact Richmond Aesthetic Surgery today.