• The Peri-areolar Mastopexy: This technique is also known as Benelli, doughnut, donut, Circum-areolar or Concentric Mastopexy and was designed with the scars being around the areolae itself.  With the per-areolar mastopexy, a donut shaped piece of tissue around the areola border is removed and the surrounding tissue sutured to the areola. The incisions are sometimes closed with "purse string" sutures to avoid scar stretching however not all patients' bodies will successfully accept permanent sutures. Sometimes a little more tissue is removed above the areola (like the crescent) to compensate for a lifting effect when it is sutured. It sometimes results in a flatter, rounder breast shape post-operatively.

• The Le Jour Mastopexy: Also known as a Lollipop, Vertical, or Keyhole Mastopexy, this technique is the same as the above but with straight incisions from under the areolae to the mammary folds (crease). This is for those who have medium ptosis, too much for the peri-areolar lift only and too little for a full anchor incision.  Although some surgeons are capable of giving very good results with the peri-areolar lift only for medium to largely ptotic patients.

• The Full Anchor Mastopexy: Also known as an Inverted T Mastopexy or Standard Mastopexy, this technique is still the most commonly used technique.  The incisions are made in the shape of an anchor at the natural crease of the breast up to the areola and nipple area.  Nipple re-positioning is almost always necessary with this technique.  The nipple is left on a pedicle to maintain circulation and nerve sensation and the areola is elevated and sutured into a higher position.  This is considered one of the major scarring techniques but it sometimes necessary with severely sagging breasts. 

• Scarless Mastopexy: Some surgeons consider the use of breast implants-only to lift the breasts as a Scarless Mastopexy.  The implants are implanted via a trans-axillary (arm pit) or trans-umbilical (navel) incision and endoscopic cameras are utilized to go in and remove a pie-shaped section of breast tissue. The remaining breast tissue is sutured together and a lifting effect is created.  Not many surgeons offer this technique so be sure to ask for many before and after photos if you consult with a surgeon who claims to perform this newer procedure.

• The Laser Bra: This procedure was innovated and named by W. Grant Stevens, M.D., F.A.C.S. of Marina Del Ray, California.  This procedure includes typical Full Mastopexy incisions but instead of discarding the excised tissue, a laser (normally a CO2 Laser) is used to de-epithelialize the skin and this tissue sewn to the chest wall to create an internal bra, or sling, to support the weight of the breast.  This procedure can be incorporated into breast augmentation and breast reduction surgeries.

• Pectoralis Major Sling:  Some surgeons are beginning to use the pectoralis major muscle to support part of the glandular tissue of the breast.  IN this procedure, the pectorals major is dissected from the wall of the chest and part of the glandular tissue is folded under and sewn to the muscle.

• Suture Suspension: This procedure utilizes typical breast lift incisions but also includes suture suspension of the glandular tissue to the breast wall.  The glandular tissue is anchored to the chest wall using non-resorbable suture material, usually nylon or polypropylene, to keep the breast tissue in its elevated position.

• Mesh Bra: In this procedure a resorbable, and sometimes non-resorbable polypropylene, mesh is used to support the breast tissue. The mesh is implanted into the breast using a small or standard incision, is placed around the breast tissue and fat and the sides and bottom perimeter of the mesh is sewn to the chest wall. 

• APTOS Thread Breast Lift: This procedure is still in the experimental stages and is for only very slightly ptotic patients.  Non-resorbable, blue, barbed polypropylene suture material is inserted into the subcutaneous fat layer of the skin using trocars and sleeves.  Once the sleeves are removed and the suture material is lightly tugged, the suture's barbs open up into the tissue and anchor the skin into a tighter, lifted appearance.  This procedure does not support the breast tissue mound and only lifts the skin.  The results are not thought to to last as long as lifts supporting the inner breast tissue.  Another risk is the possible visibility and palpability of the blue threads under the skin, skin puckering and fluid accumulation around the suture material.

 What Are The Risks & Complications Of This Procedure?
Inherent risks and complications, such as an allergic or negative reaction to anesthesia are possible.  General risks such as infection, hematoma (collection of blood within the tissue), seroma (collection of fluid in the tissues), tissue necrosis (tissue death) if adequate vascularity is not maintained either during the procedure or during the healing phase are also possible.  Suture breakage and wound separation are possible as well.  Inflammation and non-infected pus may appear around permanent and resorbable sutures.

Numbness, or loss or change in sensation, is to be expected, at least temporarily.  However, numbness can become a permanent complication.  Odd sensations, including burning, prickling, coldness, crawling, etc., during the healing process are common but should prove to be temporary.  In rare instances, increased sensation is possible resulting in a painful, overly-sensitive feeling when touched even by clothing.  Itching and redness may also occur.

Aesthetic complications are asymmetry, hyperpigmented and keloid scarring, and scar stretching.

 Who Should Perform This Procedure?
Choosing a surgeon can be the most difficult and important part of the process.  While many advise only to choose a board certified plastic surgeon, meaning only choosing a surgeon who is a member of the American Board of Plastic Surgery, verifiable on the American Board of Medical Specialties website, there is more to consider before choosing a surgeon.  Please see our special Choosing A Surgeon section with tips on how to locate and decide upon a surgeon to perform your procedure.  This section will launch in a new window for ease of reference and so you don't lose your place. 

 What Should I Expect At My Pre-operative Consultation?
Pre-surgical consultations are designed as meetings with surgeons so that you are able to evaluate what they have to offer, their preferred technique, before and after photos, anesthesia preferences and other protocol.  This is a very important step in the surgical process as this is how you will ultimately choose who to book with.

You may wish to ask if you may bring a friend for emotional support when you call or email to book an appointment.  Some surgeons don't allow this practice, while others fully understand and do not mind.  This fact will vary from practice to practice so be sure to inquire ahead of time.  You should also determine ahead of time if there is a consultation fee, more often than not you will have to pay a fee which may range from $50. to $500. to meet with the surgeon.  This fee is usually designed to separate the serious patients from those who are just interested but have no intention of ever having surgery.  Consultations may range from only ten minutes to several hours, depending upon the surgeon and sometimes this duration does not reflect upon consultation cost.

Upon arrival and check-in, you will be asked to fill out paperwork which will include your name, address, contact information as well as the contact information of an emergency contact.  Health information will be taken as well including known allergies, lifestyle (prescription and/or recreational drug-use, alcohol consumption, smoking, etc.).  Completely disclosing any known or possible condition is vital to your safety.  If you are having general anesthesia, something such as asthma or smoking can severely impact your health while you are under.  Also, be very truthful about medications you may be taking or have taken recently.

You will then meet with the surgeon for a physical examination of the body part you are consulting about, as well as discuss your options, the techniques available, anesthesia questions, or anything else you wish to inquire about.  This is an important meeting so do not be afraid to ask the surgeon anything, or give your input in any way.  

You may also wish to bring photos of breasts which you find appealing, however, with augmentation only surgeons may only be able to give you a larger version of what you have already.  

After the consultation you may be directed to a patient coordinator's office to discuss fees, financing, etc.  You am either choose to book at this meeting or wait until you are finished consulting with other surgeons.  Estimates are usually only valid for one to six months so be sure to inquire about this before you leave.

 What Are The Average Costs Of This Procedure?
This procedure averages at $3,500. to $8,000. and does not include anesthesia, operating room costs, medications or laboratory tests.  Check with each surgeon regarding costs as all practices have different fees and these fees may prove to be less if the surgeon has his or her own operating suite.  Having your procedure in a hospital often increases the associated costs.

 How Do I Prepare My Body For This Procedure?
Once you book your surgery, you are usually asked to come by for a separate meeting called a pre-operative appointment.  This procedure is designed to allow discussion of more concerns, protocol specific to the preparation, surgical and recovery process, pre-operative and post-operative instructions. At this meeting you will receive instructions on what to eat, what to take and how to prepare your body for your procedure as well as how to care for yourself after the procedure.

Typical instructions include cessation of all aspirin or vitamin E-containing products and supplements, as well as cessation of diet pills, alcohol consumption, recreational drug use, and smoking.  You should attempt to get your body in its best condition to decrease your chances of complications.  Complications can arise if you continue to consume alcohol, recreational and some prescription drugs, some supplements, and smoking.  View our chart below to give you an idea of what can happen if instructions are not followed:

Although many vitamins and supplements can be harmful before and after surgery, there are also helpful vitamins and supplements recommended to stimulate healing.  These may include Alpha Lipoic Acid, Arnica Montana, Vitamin A, Vitamin B Complex,  Bromelain, Copper, Vitamin C or Vitamin C Ester, Chromium polynicotinate, VItamin D3, Folic Acid, L-Carnitine, L-glutathione, MSM (Methyl Sulfonyl Methane), N-acetyl-L-cysteine, Niacin, Selenium, taurine, Thiamine and Zinc.  Please see our Helpful Vitamins & Supplements section.

You should discuss the desired breast size during this meeting, as well.  Although breast tissue is measured in grams, breast implant size is measured in cc/ml.  There are several available options so please discus them all with your surgeons.  You may wish to ask about High Profile (HP) implants for those who have a smaller ribcage.  HP's offer more projection and less lateral spread at the base.  This is a great option for women who are smaller framed but wish to have medium to larger breasts for their body size.  This is also the better option for medium to larger framed women who wish to have large breasts post-operatively.  

Mental preparation is also a good idea as not being prepared for your experience can cause unnecessary anxiety and fear.  Also, not knowing what to expect and cause anxiety when something as normal as bruising and discomfort arises.  Be sure that you know what to expect, what is normal, and what is not so that you are better prepared during your recovery.  Support during this time is vital, so we invite you to join us on our Breast Surgery Message Boards to speak with other patients who may be feeling exactly the same as you currently are or others who have already been through your current phase in the recovery process.

 How Is This Procedure Performed?
Please chose a procedure name for a description, with diagrams, explaining that particular technique.  For your convenience, these pages will launch in a new window.

• The Crescent Mastopexy

• The Peri-areolar Mastopexy

• The Le Jour Mastopexy

• The Full Anchor Mastopexy

• Scarless Mastopexy

• The Laser Bra

• Pectoralis Major Sling

• Suture Suspension

• Mesh Bra

• APTOS Thread Mastopexy