Breast Lift / Mastopexy

A breast lift, medically known as mastopexy, therefore addresses the shape and position of the breast. Excess skin is reduced, existing breast tissue is reshaped, and the position of the breast and nipple is adjusted according to individual anatomy. At Clinic Selnau in Zürich, planning begins with the question of what is actually the primary concern: excess skin, descended tissue, volume loss, or a combination of these.

Our Approach

Every breast changes differently. Skin quality, existing breast tissue, breast width, the inframammary fold, and the position of the nipple and areola together determine the starting point. For this reason, planning a breast lift does not begin with a particular incision pattern.

We first consider how the shape and position of the breast have changed, and which proportions should be restored or newly shaped. For some women, sufficient own breast volume is present, and a lift alone can achieve the desired shape. For others, volume is additionally missing, particularly in the upper breast. In this case, a combination with an implant or fat transfer can make sense. What matters is not removing as much skin as possible, or positioning the breast as high as possible. The aim is a shape that fits the existing anatomy and the proportions of the body.

Shape, Position & Proportions

A breast lift primarily changes the shape and position of the breast. Skin and existing breast tissue are treated so that a more compact, lifted breast shape results.

A breast lift may be considered for changes including:

• Descended breast tissue
• Lower-positioned nipples
• Downward-pointing nipples
• Excess or lax skin
• Changes following pregnancy and breastfeeding
• Changes following significant weight loss
• Loss of a previous breast shape
• Asymmetries between the two breasts
• Differing nipple positions
• A combination of tissue descent and volume loss

How much a breast has descended is not assessed by the skin alone. Also decisive are the position of the nipple relative to the inframammary fold, the distribution of breast tissue, and skin quality.

Planning & Analysis

A careful analysis forms the basis of every mastopexy. During consultation, we assess breast shape, breast width, skin quality, existing tissue, and the position of the inframammary fold. Particular attention is given to the position of the nipple and areola, and to existing differences between the two sides.

At the same time, we assess how much of your own breast volume is present, and where this volume is located within the breast. This analysis determines whether a breast lift alone is sufficient, or whether additional volume should be added. The necessary incision pattern, too, can only be determined once excess skin and the required extent of lifting have been assessed.

On this basis, a treatment plan is developed that considers shape, position, volume and scar placement together.

The Procedure

In a breast lift, excess skin is removed and the existing breast tissue is reshaped. The nipple is brought into a higher position according to the new breast shape. It typically remains connected to the underlying tissue. The areola, too, can be adjusted in size if needed.

How much skin is removed and how the breast tissue is reshaped depends on the starting point. Where descent is minor, a smaller correction may be sufficient. Where excess skin is more pronounced, a more extensive reshaping is necessary. The aim is not to lift the breast as high as possible. What matters is a position in which breast shape, nipple and body proportions once again work together in balance.

What Scars Result from a Breast Lift?

The necessary incision pattern depends on how much the breast needs to be lifted. The smaller the excess skin, the more limited the incision can be in suitable situations. More significant descent, by contrast, usually requires a more extensive reduction of skin. Different incision patterns can generally be considered.

In a periareolar lift, the scar runs around the areola. This technique is suitable only for selected situations with limited lifting needs. In a vertical mastopexy, an additional scar runs from the areola to the inframammary fold. This allows the breast to be shaped more comprehensively and excess skin to be reduced more precisely. Where descent is more pronounced, an additional scar within the inframammary fold may be necessary. This incision pattern is often referred to as the anchor or inverted-T technique.

Which incision pattern makes sense is not decided solely by the wish for as few scars as possible. A pattern that is too small can limit the possibilities for shape correction. The shortest scar is therefore not automatically the best operation. What matters is which incision pattern can meaningfully reshape the existing breast.

Breast Lift or Breast Augmentation?

A breast lift and a breast augmentation address different changes. A breast augmentation primarily creates additional volume. A mastopexy, by contrast, changes the shape and position of existing breast tissue.

Where mainly volume is missing, and the position of the breast and nipple is sufficiently stable, a breast augmentation alone may be appropriate. Where breast tissue and nipple have descended, and relevant excess skin is present, a breast lift can be the more suitable treatment. An implant can add missing volume. It cannot, however, automatically replace a necessary lift. Conversely, a breast lift can reshape existing tissue, but cannot create unlimited additional volume. For this reason, a simple question comes first: is the breast missing volume, position, or both?

Breast Lift with Implant / Augmentation-Mastopexy

Where a breast has both descended and lost volume, a lift and an augmentation can be combined. This combination is referred to as an augmentation-mastopexy. Existing breast tissue is lifted and reshaped, while additional volume is created through an implant at the same time.

Planning is more complex than for a pure breast lift or breast augmentation alone, because skin, existing breast tissue and implant need to be brought into a balanced relationship with one another. Implant size is therefore not chosen independently of the lift. A very large implant adds extra weight to the breast and, particularly with thin or already stretched skin, can have a long-term effect on tissue load. The aim, therefore, is not to combine a lift with as much volume as possible. It is to plan shape, position and volume together. You can find more about the different options for increasing volume under Breast Augmentation. Where an existing implant is being exchanged or removed alongside a lift, more detail can be found under Implant Exchange & Removal.

Breast Lift with Fat Transfer

Additional volume does not always need to come from an implant. In suitable situations, a breast lift can be combined with a breast augmentation with fat transfer. Fat tissue is harvested from suitable areas of the body, processed, and placed into the breast in a targeted way.

Fat can be used in particular to correct moderate volume deficits, support certain contours, or correct asymmetries. The possible additional volume, however, is more limited than with an implant-based breast augmentation. In addition, not all of the transplanted fat tissue integrates permanently. Whether fat transfer, an implant, or a lift without additional volume makes sense therefore depends on the starting anatomy and the desired result.

Reshaping Your Own Tissue

A breast lift does not automatically mean that additional volume is necessary. Where sufficient own breast tissue is present, this can be redistributed and reshaped during surgery to create a more compact breast shape. Existing tissue can be used to provide stronger support to certain areas of the breast and rebuild the contour.

Which possibilities exist depends significantly on how much own tissue is present, and how it is distributed within the breast. For women who fundamentally like their existing breast size but are dissatisfied with shape and position, a mastopexy without an implant can therefore be a fitting option.

Shape Does Not Come From Volume Alone

A descended breast is not automatically corrected by adding more volume. A larger implant can make the breast appear fuller, but does not necessarily change the position of the descended tissue or nipple. Likewise, a lift does not automatically mean the breast must appear smaller or less full.

What matters is how existing tissue, skin and, where relevant, additional volume are combined with one another. Shape results from their relationship to one another. A successful breast lift does not simply make the breast higher. It brings volume, shape and position back into balanced proportion.

Asymmetries

No breast is perfectly symmetrical. Differences in breast volume, nipple position, inframammary fold, or chest wall often exist even before surgery. A breast lift offers the opportunity to reduce certain asymmetries. Complete symmetry, however, cannot be guaranteed.

Where significant volume differences exist, different amounts of tissue removal, implants, or fat transfer can be part of the plan. For this reason, it is important to precisely analyse existing differences before surgery and jointly determine which of these can meaningfully be addressed.

Healing & Results

Swelling, a feeling of tightness, and changes in breast shape are normal at first after a breast lift. In the early healing phase, the breast can appear higher, firmer or unfamiliarly shaped. As healing progresses, the tissue relaxes and the breast gradually develops its more definitive shape.

Scars, too, change over several months. At first, they can appear red or firm. Over time, they usually become softer and less noticeable, but remain permanently present. Where the mastopexy is combined with implants or fat transfer, the additional treatment also influences the healing process.

The final result should therefore not be assessed immediately after surgery.

Long-Term Changes

A breast lift can significantly change the shape and position of the breast, but does not stop the natural ageing process. Skin and tissue continue to respond to gravity, pregnancies, weight fluctuations and ageing. How stable the breast shape remains long-term therefore depends, among other things, on skin quality, tissue, breast volume and life circumstances. Breast size and weight also play a role.

A mastopexy is therefore not planned only for the immediate postoperative result. The aim is a shape that remains meaningfully compatible with existing tissue quality over the long term as well.

A breast lift should not create a different breast. It should restore balance to shape and proportion.

Consultation

A breast lift begins with the question of which change to your breast is actually the primary concern. During your consultation at Clinic Selnau in Zürich, we assess breast shape, existing volume, skin quality, the inframammary fold, and the position of the nipple and areola.

We discuss what shape and proportions you would like, and what possibilities your anatomy offers. On this basis, we assess whether a pure breast lift / mastopexy makes sense, or whether additional volume is desired or necessary. Where volume is to be added, we discuss the options of a breast augmentation with implant or fat transfer, and assess whether an augmentation-mastopexy makes sense.

An important part of the consultation also concerns scar placement. We explain which incision pattern is required for the necessary extent of lifting, and where the resulting scars will be located. We discuss openly what result can realistically be expected, how the healing phase unfolds, and what limitations and risks need to be considered.

The aim is not to lift the breast as high as possible. It is to rebalance shape, position and volume so that the breast fits harmoniously with your body.