As women age, breasts may sometimes sag or become 'ptotic'. This process can be accelerated by pregnancy and nursing. Mastopexy, or breast lift, is a surgery that may be used to improve the shape of the breast, creating a more pleasing and youthful contour.

Mastopexy is usually performed under a general anesthetic, though in some cases the surgery may be performed under local anesthesia with sedation. There are several techniques which may be used; the exact procedure selected will depend on the nature and degree of ptosis. Most breast lift surgeries use incisions around the areola (the pigmented skin around the nipple), and many techniques also use a vertical incision below the nipple, and a horizontal incision that lies within the natural crease below the breast. Extra skin is removed, and the breast is reshaped to recreate a more youthful appearance. The surgery usually lasts for one to three hours, and is performed on an outpatient basis.

For those patients with mild ptosis who would also like to increase the size of the breasts, breast implants are sometimes used as an alternative to mastopexy. Occasionally, both mastopexy and breast augmentation may be useful; these procedures are sometimes staged (performed sequentially in two separate surgeries).

Pain and discomfort following the surgery are typically controlled with an oral pain medication, and stitches are removed within seven to ten days. Most patients can return to work about one week following surgery. A custom bra is often used for a few weeks after surgery, to provide support and comfort. Bruising and swelling typically resolve within one to two weeks, though minor swelling may persist for six weeks or longer in some patients.

Continue reading about breast lift surgery.

Breast Reduction

Breast reduction surgery is performed to decrease the size of the breasts, either for cosmetic purposes, or to improve symptoms which may be associated with large breasts, such as neck and back pain, and rashes under the breasts. At the time of breast reduction, the breasts are also lifted to create a more pleasing contour.

Depending on the degree of reduction required, different incisions may be used. Most techniques use incisions around the areola (the pigmented skin around the nipple), with a vertical incision below the nipple, and a horizontal incision that lies within the natural crease below the breast. Though these incisions, excess breast tissue, fat and skin are removed. Liposuction is sometimes also used to improve the contour of the breasts, and may help to limit the size of the incisions used for breast reduction. While breast reduction unavoidably creates scars on the breast, the surgery has a very high patient satisfaction rate.

Pain and discomfort following the surgery are typically controlled with an oral pain medication, and stitches are removed within seven to ten days. Most patients can return to work about one to two weeks following surgery. A custom bra is often used for a few weeks after surgery, to provide support and comfort. Bruising and swelling typically resolve within two weeks, though minor swelling may persist for six weeks or longer in some patients.

Breast reduction may also be performed in males for the treatment of ‘gynecomastia,’ or enlargement of the male breast. In most cases, the amount of loose skin is fairly limited, and liposuction is the preferred treatment. Some men with severe gynecomastia may benefit from open surgeries, which may include skin removal.

For a breast lift in Beverly Hills or a breast reduction, contact board certified plastic surgeon Dr. George Rudkin at 310.410.4599