Mastopexy - Surgical Procedures - Mastopexy of The Sagging Breast

Mastopexy of The Sagging Breast

The following descriptions of the full breast-lift and of the modified breast-lift techniques are limited to the surgical incisions used to address the skin envelope of the breast, not the internal parenchyma, the substance of the breast.

Full breast lift

The sagging bust is lifted using the circumvertical- and horizontal-incision plan of the Anchor mastopexy (also Lexer pattern, inverted-T incision, Wise pattern, inferior pedicle), which features three incisons:

• The Anchor ring: a circular incision at the upper-edge of the periphery of the nipple-areola complex.
• The Anchor shank: a vertical incision from the lower edge of the nipple-areola complex to the inframammary-fold incision.
• The Anchor stock: a horizontal incision along the inframammary fold, where the breast joins the chest.

In cutting the folds of excess skin from the sagging, inelastic skin-envelope of the breast (and occasionally reducing the nipple-areola complex diameter), the three-incision technique of the Anchor mastopexy allows maximal corrections to the breasts, thereby producing an elevated bust with breasts of natural size, look, and feel. Moreover, each of the three scars to the breast hemisphere produced by the Anchor-pattern mastopexy has a characteristic healing pattern:

• at the periareolar area — the edge of the nipple-areola complex — the surgical scar is concealed by the light-to-dark skin color at the pigment transition, where the light-color breast skin becomes the dark-color areola skin (the ring of the Anchor pattern)
• the medial vertical scar (the shank of the Anchor pattern) extends from the lower edge of the nipple-areola complex to the inframammary fold; the shadow of the breast hemisphere hides it
• the horizontal scar (the stock of the Anchor pattern), which follows, and is hidden in, the inframammary fold.

Post-surgically, of the three breast-lift surgery scars, the scar to the inframammary fold exhibits the greatest tendency to hypertrophy, to thickness and large size. Although the coloration of mastopexy scars fades with the full maturation of the tissues, they do remain visible.

Modified breast lift

The incision plans of the techniques for modified breast lift feature fewer cuts and fewer scars, but limit the plastic surgeon by allowing fewer changes to the skin envelope of the breast. In surgical praxis, the modified breast lift often is a sub-ordinate surgery within a mastopexy–breast augmentation procedure, the simultaneous lifting and enlarging the bust. Moreover, these incisions are applied to correct the ptosis discussed above; some technical variants of the modified breast lift are:

1. the periareolar lift (crescent lift), featuring a crescent-shaped incision, above and at a variable portion of the nipple-areola complex perimeter, allows the cutting and removal of a crescent of flesh, thereby facilitates the elevation (transposition) of the nipple-areola complex to its higher (new) locale upon the breast hemisphere.
2. the circumareolar lift (Benelli breast lift, donut lift), featuring the cutting out of a concentric ring of flesh from around the nipple-areola complex, limits the size and diameter of the circular scar.
3. the circumvertical lift (lollipop lift, vertical scar), featuring a circumareolar incision, around the circumference of the nipple-areola complex, and a vertical incision from the lower edge of the nipple-areola complex periphery to the inframammary fold.