Breast lift

When does a breast lift make sense?

After pregnancies, breastfeeding, significant weight loss or with increasing age, the skin loses elasticity. The breast sags and the nipples point downwards. A lift can improve shape and position. If you also want more volume, it is combined with an implant.

Techniques and scars

Which technique is suitable depends on the degree of sagging:

• Lift around the areola (periareolar) for mild sagging. The scar lies around the areola.
• Vertical lift (e.g. Lejour technique, "lollipop") for moderate sagging. The scar runs around the areola and vertically downwards.
• T-incision (anchor incision) for severe sagging and a lot of excess skin. In addition, a scar runs along the inframammary fold.

Scars are initially red and fade over the following months. After about a year at the latest, they are usually much less noticeable. Scar treatment can help.

Breast lift with implant

If volume is lacking as well as skin, the lift is combined with an implant. This can be done in one operation or in two separate stages. The doctor weighs up which approach is safer for your tissue.

Mesh support ("internal bra")

Alongside the classic technique, there are methods in which the breast is supported from the inside by a mesh. The mesh acts like an "internal bra" and is intended to hold the tissue or implant in position. Materials used include:

• Absorbable meshes, which break down after a time (for example made of poly-4-hydroxybutyrate, known under the trade name GalaFLEX).
• Titanium-coated polypropylene meshes (for example TiLOOP Bra), which remain in the body permanently.
• Acellular dermal matrix (biological tissue).

More on the page Internal bra. The aim is a more stable, longer-lasting result, especially with thin or weak tissue, when changing implants or after major weight loss. The evidence is limited. It consists mostly of smaller studies and case reports, and it has not been conclusively shown whether or for how long the result lasts better as a result. There are also additional costs and risks of their own, such as infections, fluid collections (seromas) and foreign body reactions. It is not a standard procedure, and not every clinic uses it. Whether mesh support makes sense for you is decided by the doctor after the examination.

Planning and preparation

A stable weight improves the result, as major weight changes after the operation can cause the breast to sag again. If your family planning is not yet complete, you should discuss this, as pregnancy and breastfeeding change the breast again. Before the operation, a gynaecological examination and, depending on your age and medical history, an ultrasound or mammogram are advisable.

Aftercare

After the operation you will wear a firm dressing, later a support bra. Wound fluid drains through drains. Swelling, a feeling of tightness and bruising are normal. If you have severe pain, increasing swelling or a fever, contact your doctor or your GP immediately. For the first few weeks, avoid sport and heavy physical work, and avoid sun and sunbeds for about two months.

Possible risks

General risks include infection, secondary bleeding, swelling, wound healing disorders, enlarged or thickened scars and changes in sensation in the breast and nipple. Asymmetry, impaired blood supply to the nipple and renewed sagging are also possible. Some of these can be corrected in a second operation. The ability to breastfeed may be reduced.

Keywords and downloads

Breast liftMastopexySagging breastsPregnancy and breastfeedingScarsImplant and breast lift

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