The goal of mastopexy also known as breast lift is to elevate the breast tissue, improve symmetry of the breast to enhance the aesthetics of the breast and orient the nipple areolar complex properly. To achieve this, various modifications and techniques have been suggested to enhance the appearance of ptosis or sagging breasts.
Since time immemorial, humans have been trying to correct the effects of ptosis and plastic surgery has been documented as early as 1669 when descriptions of post mastectomy reconstruction were reported. About 200 years later, Velpeau in 1854 published his analysis of mastoptosis. A century later, descriptions of the modern mastopexy procedure started emerging. Most of these early techniques contributed a lot to the modern technology behind breast lifts.
Although the initial techniques were closely linked to those of reduction mammoplasty, the emphasis was on correcting breast sagging. Most of these procedures involved elevation of the breast mound using suspension techniques; nevertheless they ushered in the era of modern mastopexy.
In most modern mastopexies, the surgeon elevates the nipple by making a semi-circular cut at the top of the areola and pulling it up. Then the surgeon remodels the tissue by making a second incision running down the base of the breast. In certain cases, the procedure may require an additional incision running at the base. Though most women would rather not have scars here, medical technology has not yet come up with a way to avoid scarring.
During breast lift procedures, doctors use barbed threads, synthetic mesh or the patient’s own skin to support the breast on the bottom as well as fat suctioned from other parts of the body to add volume to the breast.
Just as underwire bras support breasts, doctors have been experimenting with various materials ranging from artificial skin to silk in an effort to preserve the results of mastopexy. Currently, GalaFlex is showing a lot of promise. This is a polymer material spun into a strong filament and woven into a mesh 4 or 5 times stronger compared to natural breast. The crescent-shaped mesh is inserted into the lower part of the breast and is absorbed in a year or two which leaves the patient’s own tissue that has grown into it. The material is approved by the Food and Drug Administration (FDA) but is still being tested.
At the same time, cosmetic surgeons are using a new technique that may hold a lot of promise for women who have mild ptosis. The technique known as Refine supports the breast from within. It involves 2; strong, partly barbed sutures placed vertically in each breast to form a hammock that is upside down. The sutures are anchored at the top with a small incision on each breast. When they have been inserted, the barbs on the lower ends of the thread catch some tissue and can be elevated until the nipple on either side is set at the appropriate height. According to Jack Fisher, associate professor of plastic surgery at Vanderbilt University Medical Center, Nashville, Refine elevates the sagging breast and offers more volume in the upper region. In addition, the sutures can be used for extra support after mastopexy.
The technology behind breast lifts is still evolving and new techniques and approaches are emerging daily. Ultimately, after decades of women seeking to have perkier,rounder breasts, modern science is answering their needs with new mastopexy techniques to give them exactly that.