Lifting, Breast Lift, Mastopexy, Reduction, Augmentation

Gravity, pregnancy, breastfeeding, genetics, hormones, age, and other factors determine both the size and the appearance of a woman’s breasts. Gravity, in particular, inevitably leaves its mark over time, and the breasts tend to sag.

Depending on their weight, the quality of the skin, and the strength of the internal ligaments that support them, this process may begin as early as puberty or only after the age of 40–50. The so-called breast ptosis is classified into three degrees according to French surgeon Pierre Regnault, based on how far the nipple descends below the inframammary fold.

One of the main purposes of plastic and aesthetic surgery is to give or restore the breasts’ natural shape and desired volume. To simplify things, we can answer two key questions.
The first: Do we have enough breast tissue volume?
If not, we may need to transfer tissue from other areas of the body (for example, through lipotransfer) or insert a breast implant. If we do have enough existing tissue in the chest area, then naturally we will use that to recreate the ideal breast shape.

If, on the other hand, there is too much tissue and the patient wishes for smaller breasts, a breast reduction procedure will be performed — removing glandular and possibly fatty tissue from the sides during surgery.
The second question: What degree of breast ptosis is present?
The answer will determine the surgical technique used for breast lifting, also known as mastopexy.

As you may have deduced, breast lifting (mastopexy) corrects sagging breasts by removing excess skin and reshaping the glandular tissue to achieve a long-lasting, natural, and aesthetic contour.
When there is also an excess of breast tissue — known as macromastia, breast hypertrophy, or gigantomastia — the procedure removes not only excess skin but also part of the glandular tissue.

Therefore, breast reduction overlaps significantly with breast lifting, using many of the same surgical techniques.
When there is insufficient breast volume but excess tissue in the flanks or axillary region, that tissue can be repositioned through extended incisions and transferred to the breast.
This technique, first described by American surgeon Dr. Peter J. Rubin, is an excellent method for breast auto-augmentation, allowing enhancement without the use of implants.

For athletic patients whose breasts are sagging and completely lacking residual volume — and for whom lipotransfer is not possible — the insertion of breast implants is recommended. This procedure is usually combined with a mastopexy to achieve optimal breast shape.

To clarify some recent misconceptions seen in the media, it must be emphasized that inserting a breast implant during a breast reduction is never justified — a patient’s own tissue is always preferable to a foreign body such as an implant.
Additionally, breast auto-augmentation refers to the addition of viable autologous tissue (usually from the flank or axillary region) to the breast, whereas breast lifting (mastopexy) reshapes the existing breast tissue while correcting sagging.

For more information about breast surgery, you can contact me online or schedule a consultation.