The breast loses firmness over the course of life. Pregnancy and breastfeeding, major weight loss, hormonal changes and the natural ageing process stretch the tissue; the skin does not fully retract afterwards. The breast appears flatter, the areola moves downwards and the volume shifts into the lower part.
During a breast lift (mastopexy) no glandular tissue is removed. The existing tissue is brought back to the position it originally held, excess skin is removed and the areola is moved upwards. The breast does not become smaller, but firmer and higher.
Causes of sagging
- pregnancy and breastfeeding
- major weight loss
- hormonal changes
- the natural ageing process
- weak connective tissue as a predisposition
Consultation for a breast lift
Dr Özdemir examines how far the areola has descended, how much excess skin there is and how much of your own glandular tissue is present. From this it follows whether a lift alone is sufficient or whether further steps make sense.
He informs you about the surgical procedure, about risks and possible complications as well as about the costs. The practice is a private practice only; there is no health insurance contract.
Which incision techniques are there?
The same three incision patterns are available as for a reduction. Which one applies depends on the excess skin and on how far the areola needs to be raised.
The O-technique (circular method) leaves only a scar around the areola and is sufficient for minor excess skin. The I-technique (Lejour method) adds a vertical scar. The T-technique (anchor method) additionally takes up a scar in the inframammary fold and suits pronounced findings.
The internal bra
During a lift no tissue is removed. The new shape arises solely from redistributing the existing tissue, and it must therefore be held from within. Here the internal bra is not an additional measure but the prerequisite for a lasting result.
For this, part of your own tissue is de-epithelialised: the uppermost layer of skin is removed while the tissue underneath is preserved. It is folded over and sutured at the level of the pectoral muscle. The result is a supporting structure made from your own material that holds the breast from within. Without this internal suspension, a breast held by skin alone would sink again over time.
Raising the areola
Unlike a reduction, a lift usually does not require a pedicle of the areola. Dr Özdemir works periareolarly: around the areola, with a larger portion above it, the uppermost layer of skin is removed, and the areola is raised to its new position.
Where that position lies is marked before the operation with you standing. Lying down changes the shape of the breast; only in a standing position can it be judged where the areola should actually sit afterwards.
Course of the operation
The operation is performed under general anaesthesia in a private clinic in Vienna and takes about two hours. You then stay preferably two nights in hospital.
At the end of the operation, drains are placed to drain wound fluid. When they are removed depends on the amount of fluid. The sutures dissolve by themselves; no suture removal is needed.
Lift combined with an implant
If you also wish for more volume, the lift can be combined with an implant. This procedure is called augmentation mastopexy, is considerably more complex and takes at least five hours.
Dr Özdemir does not recommend it lightly. An implant adds weight to the breast and thus loads precisely those structures the lift has just restored, so the durability of the result decreases. If enough of your own glandular tissue is present and you are fundamentally satisfied with your volume, the better approach is to move that tissue back to where it originally sat. The result is a firmer breast made from your own material, without a foreign body and without additional weight.
After the breast lift
For six weeks you wear a compression bra day and night. Afterwards you can switch to a sports bra as long as it has no underwire.
The follow-up appointments have a fixed schedule:
- two to three days after discharge, if drains are still in place
- after about two weeks, when the Steri-Strips around the areola are removed
- after six weeks
- after three months
- after one year for the final check
Reddish discolouration and swelling during the first weeks are part of the healing process. The final result can be assessed after six to twelve months, once the swelling has subsided and the scars have matured.
Scars
Every lift leaves scars; how extensive they are depends on the incision chosen. At first they are reddened and clearly visible, over months they fade and become flatter. How well they mature also depends on your disposition and on scar care.
Requirements for a good result
- Stopping smoking before and after the operation. Nicotine impairs blood flow and thus wound healing.
- BMI below 32 as a guide value; one point above or below is acceptable in individual cases.
- Completed family planning. A pregnancy stretches the tissue again.
- Stable weight: the target weight reached and held for at least six months.
Surgery is not performed in the case of blood thinning that cannot be paused, for example after pulmonary embolism, stroke or heart attack, or in the case of pronounced obesity.
Why there are no before-and-after pictures
You will not find before-and-after photos on this page, and Dr Özdemir does not show any during the consultation either. Initial findings, tissue quality, skin tension and body build differ so much from patient to patient that another woman's result says nothing about what to expect in your case.
What you receive instead: an examination of your findings and an honest assessment of what result is realistic for you.
