Breast Lift (Mastopexy)

A breast lift, also known by the medical term mastopexy, is an operation that reshapes the breast and repositions it higher on the chest wall. The surgery removes excess skin and repositions the breast tissue and the nipple, generally without significantly changing breast volume. The change in shape often gives the impression of greater fullness in the upper part of the breast, even though no volume has been added, simply because the breast tissue is held in a higher position by the tighter skin envelope.

If volume is also part of what you’re hoping to address, a lift can be combined with implants or with fat transfer in the same operation. Those combined procedures have their own pages, with information on the additional considerations that apply when two operations are performed together. The information on this page covers a standalone breast lift.

Changes in breast shape and position over time are part of life. Pregnancy and breastfeeding stretch the skin envelope and reduce breast volume. Weight changes alter the proportion of fat in the breast. Gravity and ageing gradually move the breast tissue into a lower position on the chest, with the nipple often shifting from its original level. None of this is a medical problem, and there’s no clinical pressure on anyone to have a breast lift just because their breasts have changed.

A lift can be considered when these changes are present and you’re interested in changing the position or shape of the breast. The decision is personal, and the option of not having surgery is always part of the conversation we have at consultation. We’ll spend time discussing what you’re hoping the surgery will achieve, what’s realistic, and whether a lift on its own will produce the result you want or whether a combined procedure is more likely to suit.

Plastic surgeons grade the degree of breast droop, the medical term for which is ptosis, by where the nipple sits in relation to the inframammary fold (the natural crease beneath the breast). Mild ptosis describes a breast where the nipple sits at the level of the fold. Moderate ptosis describes a breast where the nipple sits below the fold but still points forward. Severe ptosis describes a breast where the nipple sits well below the fold and points downward.

There’s also a separate condition called pseudoptosis, where the breast tissue itself sits low but the nipple remains in a normal position. Pseudoptosis is addressed differently to true ptosis, and the assessment we do at consultation includes working out which pattern applies to your situation. The grade of ptosis is one of the most important factors in deciding which lift technique is most appropriate.

There are three commonly used lift techniques, each with its own scar pattern and each suited to a different range of breast presentations.

A breast lift is performed under general anaesthesia in an accredited hospital, with the operation usually taking between two and three hours. Most patients stay overnight and are discharged the following morning, although the duration of stay depends on the operation, the patient, and the anaesthetic.

During surgery, the breast tissue is reshaped, the nipple is repositioned on a pedicle of tissue that maintains its blood and nerve supply (with the specific pedicle design depending on the technique used), and excess skin is removed. The areola can be reduced in diameter as part of the same operation if it has stretched, which is common in patients with significant ptosis.

The first 48 to 72 hours after surgery are usually the most uncomfortable, with most patients describing tightness across the chest and moderate pain that responds well to oral analgesia. After that, discomfort settles steadily through the first week. A surgical bra is worn around the clock for several weeks, including overnight, to support the reshaped breasts while the tissues heal and to reduce tension on the suture lines.

Heavy lifting, vigorous exercise and overhead activities should wait around six weeks while the wounds heal and the reshaped tissues consolidate. Most people with desk-based jobs are back at work after one to two weeks, while patients in physical roles need longer. Recovery experiences are individual, and we’ll give you advice specific to your situation, including a recovery timeline that’s realistic given the technique used and the work you do.

Final breast shape continues to develop over several months as swelling settles, and scars take 12 to 18 months to mature, going through a phase of being more pink or red before fading. Scar appearance varies between patients depending on individual healing characteristics.

Possible complications include:

A standalone breast lift won’t make you noticeably bigger or smaller. The change in shape sometimes gives the impression of more upper pole fullness, but no volume has actually been added. If volume is part of what you’re hoping to address, a lift combined with implants or with fat transfer is more likely to deliver the result you have in mind. Those combined options have their own pages with information on the additional considerations that apply when two operations are performed together.

Dr Henry Shepherd, BMed MD MS (Plast.) FRACS (Plast.) | Specialist Plastic Surgeon | AHPRA registration: MED 0001860545