Do I Need a Breast Lift (Mastopexy)?

Published April 10, 2018

Do I Need a Breast Lift (Mastopexy)?

Dr Tavakoli’s Green, Yellow and Red zones for mastopexy surgery

Women seek to change the appearance of their breast for many different reasons. Some desire an increase in size whilst others may want to change the shape of their breasts. Whatever your reasons are for wanting a breast augmentation mammoplasty, you may be asking yourself, do I also need a mastopexy (breast lift)?

Following pregnancy or weight loss, it is not uncommon for the breast to change in appearance. For women with naturally small breasts, these fluctuations can lead to excess skin. For women with fuller breasts, these changes may cause the breasts to drop downwards (ptosis).

Depending on the severity of the breast ptosis and patient expectation, a breast lift, or mastopexy, may be required.

What is a breast lift (mastopexy)?

Also called a mastopexy, a breast lift is a surgical procedure that lifts and reshapes the breasts by removing excess skin. A mastopexy, in combination with fat grafting or breast implants can also add volume to the upper pole, which may have been lost with ageing, genetics, weight loss, pregnancy and/or breastfeeding.

During a mastopexy surgery, the areola and nipple can be resized and is moved to a higher position on the breast.

Do I need mastopexy surgery?

One of the more frequent questions patients ask Dr Tavakoli is, do I need mastopexy surgery? Having performed over 6000 breast procedures in his career, Dr Tavakoli has developed his red, yellow and green system for categorising mastopexy patients.

Green Zone

If a patient has mild decent of the nipple areola complex but the overall shape is satisfactory then a mastopexy will not be necessary. These patients generally respond well to a breast augmentation mammoplasty with an appropriately sized breast implant.

Yellow Zone

Sometimes referred to as the ‘borderline zone’, yellow zone patients are slightly more complex. In yellow zone patients, a breast implant alone will not completely lift the nipple areola complex but it does change the overall shape of the breast.

Patient expectation is key for yellow zone patients. If the patient expectation is high, a breast lift or mastopexy will need to be performed in combination with the breast augmentation mammoplasty procedure. However, if the patient is young or would like to avoid scars, then a mastopexy can be used. This involves the use of selected anatomical (teardrop) implants in a customised high dual plane pocket.

Mastopexy achieved with CPG 333, 545cc anatomical (teardrop) implants in a high dual plane pocket. Shown here at 7 months post surgery

Red Zone

In red zone patients, the breasts and nipple areola complex have descended to such a level that a breast implant alone will not be sufficient for achieving the patient’s goals. All patients in the red zone require some form of breast lifting (mastopexy) along with implant or fat grafting (augmentation mammoplasty). This may be performed as a one stage or two stage procedure.

Why do some patients require a two stage procedure?

For some women who require a mastopexy, they may be advised to undergo a mastopexy and breast augmentation mammoplasty as a two stage procedure.

If you have been advised that you need a two stage procedure then you are probably wondering why. Dr Tavakoli explains that the need for a two stage procedure correlates directly with the level of ptosis in the breasts. For Dr Tavakoli, there are two main factors to take into account:

  1. Amount of nipple descent in relation to the torso: As a rule of thumb, if the level of ptosis is more then 30-40% away from the desired breast placement, then a two stage procedure is necessary.
  2. Skin quality: The quality of the skin is also a key factor in determining whether or not to perform a staged procedure. If the skin quality is poor, usually indicated by the presence of stretch marks, then caution should be exercised. An implant, even small in size can alter the position of the mastopexy. Waiting 6-12 months after the initial mastopexy is usually appropriate in these cases.

Important things to know about mastopexy surgery

Breast implants have their own set of problems and are not always required in mastopexy patients, even if they desire them.

If the breasts are already large but have shifted down or become ptotic then a good option may to use the patients own breast tissue along with fat grafting to reshape and remodel the breasts.

Read more about breast reshaping with fat grafting here.

What is the recovery like for mastopexy?

For more information on the mastopexy recovery times see here.

Published By: Dr Kourosh Tavakoli

Dr Kourosh Tavakoli, MS, FRACS, is an Australian-trained plastic surgeon with over 20 years of surgical training. He is an active member of the International Society (ISAPS) and the American Society of Plastic Surgeons (ASAPS). He is knowledgeable in plastic surgery of the breast and body and lectures extensively around the world on these topics.