Mastopexy is an operation to restore a youthful, uplifted appearance of aging breasts that have sagged and lost their shape. This is not a permanent solution, since time and the forces of gravity will eventually cause recurrent drooping. There are two big tradeoffs to achieve this uplifted condition: permanent scars on the breasts and possible loss of sensation in the breasts to include the nipple area. Many women are confused in their expectations of this operation. They want lovely, uplifted breasts with superior fullness without visible scars. This is not realistic, nor is it possible to achieve. Breast ptosis (droop) may occur at a relatively early age - during puberty or the late teens. It frequently develops after pregnancy and lactation. It may be related to obesity and larger breasts. It is quite common after menopause.

Before a mastopexy, the loose ptotic breast is observed to flow and project outward. With a mastopexy, the skin envelop is tightened which results in some loss of projection. This results in the perception that the breasts look smaller when viewed from above. Many patients expect a mastopexy to restore upper pole fullness and “cleavage”. This will not be possible without the addition of a breast implant. Many women may not want implants, and they think that they only need their breasts to be tightened and raised. If the patient has mild droop, breast implants alone without mastopexy may be a better solution because there will be less scarring and sensory disturbance. If there is moderate to severe droop, breast implants alone will not solve the problem, and could make the condition look worse. In these cases, especially if the patient wants to restore upper breast fullness, a combination of mastopexy and augmentation with implants is the best solution. If implants will be used, it is important that the patient understand all aspects and potential problems associated with breast implants.

When the patient is overweight, it is best to lose weight before this surgery. There may be some loss of breast volume and recurrent breast droop if substantial amounts of weight are loss after surgery. This is unpredictable.