Understanding Mastopexy

Let me be frank with you—gravity isn’t your friend. After 20 years of performing breast surgeries, I’ve heard countless women express the same concern: “Dr. Cohen, my breasts just don’t sit where they used to.” If you’re nodding along, you’re not alone. Today, let’s have an honest conversation about mastopexy, commonly known as a breast lift, and what it can realistically do for you.

Think of your breasts like a favorite sweater. Over time, the elastic fibers stretch out, and what once fit perfectly now hangs differently. That’s essentially what happens to breast tissue—pregnancy, breastfeeding, weight fluctuations, and yes, good old gravity, all play their part. A mastopexy is like taking that sweater to a skilled tailor who can restore its original shape without changing its size.

What Exactly Is a Mastopexy?

A mastopexy is a surgical procedure designed to lift and reshape sagging breasts. According to organization guidelines, we remove excess skin, reposition your nipple-areola complex to a more youthful height, and reshape the remaining breast tissue to create a firmer, more lifted appearance.

Let me paint you a picture. Imagine your breast as a water balloon sitting in a fabric bag. Over time, that fabric stretches and the balloon settles lower. During a mastopexy, we essentially tailor that fabric bag—removing the excess, tightening what remains, and repositioning everything to sit higher on your chest wall.

The procedure typically takes 2-3 hours and is performed under general anesthesia in our AAAASF-accredited surgical facility. This accreditation isn’t just a fancy certificate on the wall—it means we meet the highest standards for patient safety, equipment, and staff training.

Now, here’s something crucial I tell every patient: a breast lift doesn’t significantly change your breast size. If you’re looking to go bigger or smaller, we need to discuss combining your lift with augmentation or reduction. Think of it this way—a lift changes position and shape, while implants or reduction change volume.

Are You a Good Candidate?

Let’s talk candidly about who benefits most from this procedure. The ideal candidate for mastopexy typically experiences one or more of these concerns:

• Your nipples point downward or fall below your breast crease when unsupported. I use what I call the “pencil test”—if you can hold a pencil under your breast without a bra, you’re likely experiencing ptosis (the medical term for sagging).
• You’ve noticed your breasts have lost their shape and volume, particularly in the upper portion. Many women describe this as looking “deflated” after pregnancy or weight loss.
• Your areolas have stretched out of proportion to your breast size. This often happens alongside general breast sagging.
• One breast sits noticeably lower than the other. While some asymmetry is normal, significant differences can affect how clothes fit and impact self-confidence.

The Surgical Techniques

In my practice, I use three main incision patterns, and the choice depends entirely on your degree of sagging and desired outcome. Let me break these down in terms you can visualize:

1. Circumareolar

The “donut” or circumareolar technique works best for mild sagging. We make an incision around your areola, remove a ring of skin, and lift everything slightly. Think of it like gathering fabric around a button—minimal scarring, modest lift.

2. Vertical

The “lollipop” or vertical technique suits moderate sagging. This involves an incision around the areola and vertically down to the breast crease. It allows more significant lifting and reshaping while avoiding the horizontal scar.

3. Anchor

The “anchor” or inverted-T technique addresses severe sagging. We add a horizontal incision along the breast crease to the lollipop pattern. Yes, it means more scarring, but it also provides maximum lifting and reshaping capability.

During your consultation at our Newport News office, we’ll examine your breast position and skin quality. We also do a set of anatomic breast measurements which reflect the degree of ptosis as well as a number of other relevant characteristics. We then discuss your goals to determine the best approach.

What to Expect

Recovery and Results

Here’s what I tell patients about recovery: plan for a week off work if you have a desk job, three to four weeks for more physical occupations. You’ll wear a surgical bra continuously for the first month—think of it as scaffolding while your breasts heal into their new position.

The first few days involve managing discomfort with prescribed pain medication. Most patients describe it as tightness rather than sharp pain. By day three or four, many switch to over-the-counter pain relievers.

Swelling peaks around day three and gradually subsides over several weeks. Your breasts will initially sit high on your chest—almost unnaturally high. Don’t panic. Over 3-6 months, they’ll settle into their final, natural-looking position.

Exercise restrictions are important. No heavy lifting or vigorous upper body movement for six weeks. I tell patients to treat their breasts like delicate glass ornaments during this time—handle with extreme care.

Scarring is often the biggest concern I hear. Let me be honest: all breast lifts result in some scarring. However, scars typically fade from dark to skin color over 18-24 months. We provide detailed scar care instructions and can recommend treatments to optimize healing.

Investment and Value

Depending on the severity of ptosis and duration of the procedure, mastopexy cost can range from $6000 to $9000 total, including operating room fees and anesthesia fees.

Getting Started

Making Your Decision

After two decades in plastic surgery, I’ve learned that the best outcomes happen when patients are fully informed and have realistic expectations. A mastopexy can dramatically improve breast shape and position, boosting confidence and expanding wardrobe options. However, it’s still surgery with recovery time, potential risks, and permanent scarring.

If you’re considering a breast lift, I encourage you to schedule a consultation. Call our Newport News office at (757) 347-0636 or visit pschr.com. During your visit, we’ll perform a thorough examination, discuss your goals, and create a personalized surgical plan.

Remember, this decision is deeply personal. Whether you’re restoring your pre-pregnancy figure or addressing age-related changes, your goals matter. Our team at Plastic Surgery Center of Hampton Roads is here to provide honest guidance, exceptional surgical care, and support throughout your journey.

Your breasts have been with you through life’s changes—pregnancies, weight fluctuations, the passage of time. If they no longer reflect how you feel inside, mastopexy might be your solution. Let’s work together to help you feel confident and comfortable in your own skin again, and get started today on your transformation journey.