Mastopexy (Breast Uplift) & Augmentation Mastopexy

As with many parts of our bodies that change with time, the look of our breasts also changes.  They lose firmness, usually volume too, the skin loses its former elasticity and so the breasts start to droop. These changes are accelerated by pregnancy/breast feeding and significant weight loss.

Essentially, the degree of breast sag (medically known as “Ptosis”) will determine the design of the Mastopexy required.  With a Mastopexy, only the excess loose skin is removed, not breast tissue.  Varying amounts and patterns of breast skin are removed in order to tighten the skin over the existing breast tissue.  This skin removal restores the tightness of the breast envelope which in turn produces ‘lift’ and elevates the nipples to a higher, more desirable position.

Causes of Ptosis

With age, every woman’s breasts change in size and volume as:

  • the skin envelope becomes looser; and
  • the supporting Cooper’s Ligaments within the breast itself – and whose function is to hold the breast up high on the chest wall – become weaker and allow the breast to droop.

These changes are accelerated by pregnancy and breast-feeding.

The main groups of women presenting with breast ptosis are as follows:

  1. Young women with large breasts in whom the breasts have sagged from the sheer weight and volume of the breasts.
  2. Women after pregnancy and breast-feeding due to the overstretching of the breast skin and the subsequent shrinkage of the breast tissue when finished leaving the breasts smaller and saggy.  These changes occur because the breasts:
  • lose volume through shrinkage of the breast tissue and milk glands; and
  • the overstretched breast skin does not return to its former condition leaving the skin envelope looser.
  1. Post-menopausal women due to progressive loss of breast tissue and skin elasticity.
  2. Women of any age following major weight loss

Degrees of Ptosis

Breast lift techniques

Various surgical techniques are available to the surgeon for Breast Lifting and they are colloquially named according to the pattern of the final scars.

Whereas very minor degrees of ptosis can be corrected by the insertion of implants alone, the more advanced degrees of ptosis require one of the following types of Mastopexy – each given its descriptive name based on the pattern of the final scars:

  • Crescent Mastopexy is the least extensive breast lift and involves removing a crescent of skin above the areola.  Sometimes, it is necessary to extend the incisions a little sideways in which case it then changes its name to a Batwing Mastopexy as follows.
    Mastopexy
    The other more extensive patterns of Mastopexy are:
  • Circum-areolar Mastopexy(also known as a Benelli Lift or ‘Doughnut Pattern’ Lift).  This involves removing a ‘doughnut’ pattern of skin from around the areola.  Its ability to “lift” is limited and it may cause some flattening of the breast. By nature, it does leave variable degrees of puckering of the scar which may or may not completely disappear over time.
    circumareolar-mastopexy
  • Vertical Mastopexy (Vertical Scar Mastopexy or ‘Lollipop’ Lift)
    vertical-mastopexy
    This is a very effective lift for moderately sagging breasts.
  • Wise Pattern Mastopexy (‘Anchor’ Pattern) is the most extensive lift and is used for major degrees of sagging.
    wise-pattern-mastopexy

Mastopexy alone may well suffice if a woman is happy with the size of her breasts and is only concerned about the sagging.  With a Mastopexy alone, the breasts are lifted but remain the same size.  If, however, a woman wishes to also increase the size of her breasts, implants would need to be inserted at the same time and this is known as an Augmentation Mastopexy.

Mastopexy Surgery is eligible for a Medicare Item Number and part-rebate if you meet Medicare’s criteria which in 2018 are:

Item 45558: “BREAST PTOSIS, correction of by Mastopexy by any means (bilateral), following pregnancy and lactation, when performed not less than 1 year, and not more than 7 years after the end of the most recent pregnancy, and where it can be demonstrated that the nipple is inferior to the infra-mammary groove”

If your Breast Ptosis satisfies all the above criteria you will qualify for the above Medicare Item Number. If you also have Private Hospital Insurance, a variable portion of the Hospital Fees can also be claimed depending on your Fund and level of Cover.

PLEASE NOTE:

If you only have a very mild degree of Ptosis known as ‘Pseudo-ptosis’ (where the breast mound has fallen below the breast crease but the nipple is still above it – see diagram above), you MAY NOT need a formal Breast Lift as Pseudo-ptosis can often be corrected by implants alone.

FAQ’s about breast lifts

  • How long does the procedure take?
    This will depend on the design of the Breast Lift and can take as little as 2 hours for a minor ‘Lift’ to 4½ hours for an ‘Anchor Lift’.
  • Do I have to stay in hospital?
    Usually yes, but for one night only.
  • Is there any scarring and do the scars eventually disappear?
    Yes, the extent of the scarring depends on the pattern of skin excision required as shown above. Although the scars never totally disappear, they do become less conspicuous with time.
  • What is the recovery time?
    Unless you are also having implants inserted to increase the size of the breasts, recovery is fairly quick as only excess skin will be removed. Generally, this is around 7-10 days.  However, it does takes a number of months for your breasts to assume a more natural, rounded shape after the more advanced Breast Lift techniques.
  • Costs involved:
    If your Breast Ptosis satisfies ALL the following Medicare criteria you will qualify for a partial rebate from Medicare.
  • If the Ptosis follows a pregnancy. (Ptosis from major weight loss doesn’t qualify); AND
  • The Mastopexy is performed not less than 1 year, and not more than 7 years after the end of the most recent pregnancy; AND
  • where it can be demonstrated that the nipple is below the level of the infra-mammary groove”

If qualify for a Medicare rebate, and if you also have Private Hospital Insurance, a variable portion of the Hospital Fees can also be claimed depending on your Fund and level of Cover.

Breast lifts + implants (Augmentation Mastopexy)

  • If a woman is happy with her breast size and is only bothered by the Ptosis, only a Breast Lift is necessary.
  • However, as is usually the case, if the woman has also lost breast volume and desires the breasts to be larger as well, implants need to be inserted. Naturally, this will increase the duration of the surgery and accordingly the final costs as well.
  • Although implants are usually inserted at the same time as the Breast Lift, some surgeons recommend waiting 6 months after the Breast Lift before inserting implants.