Breast Lift / Mastopexy

“Beauty Through Mastery” Serving Miami, Boca Raton, Florida and surrounding areas

There are several factors that contribute to aging of a woman’s breasts. The first factor is age itself. Although each patient is unique with regard to the amount of breast tissue and skin quality, nobody is immune to the effects of gravity and time. With time, the tissue and skin of the breasts begin to relax and descend. Furthermore, skin has a tendency to stretch and lose elasticity with age. This may lead to a sagging appearance of the breasts referred to as breast ptosis (pronounced toe-sis).

Pregnancy and breast feeding can also lead to aging of the breasts. With pregnancy and breast feeding, the breasts become engorged followed by eventual deflation. This cycle of engorgement and deflation leads to a gradual relaxation of the skin and breast tissue and may lead to a deflated appearance, as well as breast ptosis.

Significant fluctuations in weight may also have an effect on the appearance of the breasts. Some women experience an increase in size of the breasts with weight gain, followed by a decrease in size of the breasts with weight loss. Once again, this increase in volume followed by a decrease in volume may lead to a stretching and relaxation phenomenon of the breast tissue, which can lead to a deflated appearance and breast ptosis.

Often times, it is a combination of some or all of these factors that contribute to aging of the breasts and eventual breast ptosis. There is a very wide spectrum of breast ptosis that ranges from mild to severe. In severe cases, in addition to sagging of the breast tissue, the position of the nipple and areola are also affected. A widening of the areola may occur in addition to a downward pointing orientation of the nipples.

A “breast lift,” or mastopexy, is a procedure designed to restore the position and shape of the breasts, while also correcting the position of the nipple and widening of the areola.


There are several goals of a mastopexy as follows:

  • Restoring a more youthful shape to the breasts
  • Correction of sagging
  • Restoring the appropriate position of the nipples
  • Correction of widening of the areola

Dr. Paul N. Afrooz explains to breast lift patients that the “trade-off” in a mastopexy is that incisions on the breast are traded for improvement in breast shape and contour. The incision design for a mastopexy is placed around the areola, and downward from the bottom of the areola to the breast crease. In a standard mastopexy design, an incision is also placed in the breast crease. The degree of correction necessary usually dictates the extent of the incisions.

In certain cases, an implant can be placed at the time of mastopexy. The addition of an implant can help restore volume and shape to the breasts. However, there are limitations to combining these two procedures. The ultimate goal is to restore a youthful, aesthetically-pleasing appearance of the breasts for the long term. Sometimes this requires performing the mastopexy and placement of the implant in separate surgeries in order to ensure the best possible result. Dr. Afrooz will discuss each individual patient’s goals and expectations, and design the best treatment plan to achieve the desired long term result.


Women, who have experienced deflation and sagging of the breasts due to normal aging, or pregnancy and breast feeding, are excellent candidates for mastopexy. In addition, women who have had significant weight loss are excellent candidates.
In general, a mastopexy should be deferred until there are no plans for future pregnancy, so that the benefits of the procedure are not lost. Weight loss patients should be at a stable weight for approximately 1 year prior to a mastopexy procedure.


In addition to extensive discussion and preoperative planning, preoperative markings will be made on the day of the procedure. These preoperative markings include precise measurements and serve several purposes. First, it is an excellent way to facilitate additional discussion and communication with the patient by demonstrating the placement of incisions, and the goals of the procedure. Furthermore, these markings are placed in the standing position in order to appreciate the effects of gravity on the breasts. This appreciation is no longer as apparent when the patient is laying down on the operating room table. Therefore, these markings serve as useful guide during the procedure.

The procedure takes place under general anesthesia to ensure maximum patient comfort and safety. Often times, the mastopexy procedure involves placing the operating room table in the sitting position to visualize the appearance of the breasts with the effect of gravity. General anesthesia with placement of a secure airway facilitates these position changes with maximum safety. Furthermore, our anesthesiologists are board certified and use state of the art monitoring equipment for all procedures in our surgery center.

If placement of a breast implant is combined with a mastopexy, the implant is usually placed first. Then, the mastopexy procedure begins with an incision within the areola. This incision dictates the new size of the areola, and is approximately 4 cm in diameter with variation for each individual patient. The nipple and areola remain attached to the underlying breast tissue at all times, while the skin of the breast around the areola is lifted off of the underlying breast tissue. Depending on the degree of the lift and reshaping required, the incision may extend down from the bottom of the areola to the breast crease. Sometimes an incision is made in the breast crease as well. A layer of skin and breast tissue are precisely separated from the underlying breast tissue. The underlying breast tissue is reoriented and placed into a higher position along the chest wall. The skin is then laid over the breast tissue and precisely tailored to remove redundancy, correct ptosis, and achieve a tighter skin envelope around the breast tissue.
Once the desired shape and contour of the breasts are achieved, a circular cutout of skin is made in the breast skin for the nipple areola complex (NAC). The nipple is then inset into a new, higher position.

Soft gauze dressing is placed over the incisions, and a supportive garment is placed at the conclusion of the procedure.


Patients may have mild soreness after the mastopexy procedure for approximately 48 hours. Oral pain medications are prescribed to alleviate any pain or discomfort during the initial recovery. Slight bruising may occur and usually resolves within two weeks. Combining a mastopexy with a breast implant may cause more soreness, particularly if the breast implant is placed under the muscle.*

Patients may return to work one week after a mastopexy as long as physical labor is not involved. Progression of activity can ensue at 10 – 14 days, and return to regular activity can usually take place at 4 weeks. If an implant is placed at the time of the mastopexy, recovery is slightly longer, and return to normal activity without restrictions is approximately 6 weeks.*

The surgical bra should remain in place for 24 hours a day for the first 3 weeks after surgery, and then for 12 hours a day for an additional 3 weeks. Underwire bras should be avoided for 6 weeks following surgery.*


Achieving the ideal breast surgery results requires a strong sense of aesthetics, a thorough understanding of anatomy, as well as surgical skill and experience. Dr. Paul N. Afrooz completed a fellowship in aesthetic surgery after his general training in plastic surgery, and has a particular interest in breast augmentation, and body contouring procedures.

In addition, Dr. Afrooz’s philosophy is not simply to increase the size of the breast, but to achieve natural-looking results that improve the feminine shape and contour of a woman’s body.

If you are considering a breast lift procedure, we encourage you to set up a consultation with Dr. Paul N. Afrooz to discuss your options.

To discover how a breast augmentation or lift can improve your appearance, confidence, and total outlook on life, please call our office today 305.854.8828 to schedule your confidential consultation with Dr. Paul N. Afrooz.

*Results may vary. Consult with the experienced plastic surgeons at the Institute of Aesthetic Medicine to see if you are a good candidate.