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To breast lift or not to breast lift?


Patients often state that while they are unhappy with the appearance of their breasts, they don't know whether or not they need a lift. A mastopexy, or breast lift, is a surgical procedure that raises the breast tissue and nipple by removing excess skin and reshaping the breast to a more youthful contour.

Many women are familiar with the "pencil test," as an informal test they use to try to decide if they need a breast lift. This involves placing a pencil at the breast crease where the underside of the breast meets the chest wall (aka the inframammary fold), and if the pencil stays in place by itself rather than falling down, the breasts may have drooped enough to need a breast lift. While this can be a helpful trick, it's not entirely precise, and not exactly the same approach plastic surgeons use!

So, what causes the breasts to sag, and how do plastic surgeons evaluate whether a patient is a good candidate for a breast lift?

Are you a good candidate for a breast lift?

With aging, pregnancy, breastfeeding, weight changes, genetics and gravity, the breast tissue loses its elasticity and the breasts begin to droop, which is called ptosis. The degree of ptosis is classified according to the position of the nipple.

In general, a nipple positioned at or above the level of the breast fold is desirable, and nipple positions that descend below the fold with the nipple ultimately pointing towards the ground constitute the highest degree of ptosis. Any degree of nipple drooping below the fold may indicate that a breast lift is needed. There are instances in which the nipple is at the level of the breast fold but the breast tissue itself has drooped lower, known as "pseudoptosis," and these patients may still be candidates for a breast lift.

What about scarring after a breast lift?

While patients are understandably often concerned about the extent of scarring after a breast lift, the scar fades over time. I tell my patients that achieving a beautiful shape is the most important thing. Along with the meticulous approach of a skilled, board-certified plastic surgeon to minimize scarring, there are also numerous scar creams and lasers that can further contribute to enhanced scar healing.

The type of incision for a breast lift – around the nipple (periareolar), lollipop or anchor scar – is generally based on how much of a lift is required. During the surgery, the nipple and areola are raised to a more youthful position, the enlarged areola is reduced to an appropriate size, the excess skin and tissue is removed and the remaining tissue is reshaped to create the new tighter and higher breast contour.

Ready to take the next step on your breast lift journey?

Do you think you might benefit from a breast lift? Seeking an evaluation by a plastic surgeon who has experience with breast lifts and breast lifts with implants is the first step to ensuring a safe and beautiful result. Be sure to find a board-certified plastic surgeon in your area to set up a consultation.


The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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