The Different Techniques
Mastopexy without implants
- Indication: moderate to severe ptosis when breast volume is satisfactory.
- Main scar techniques:
- Peri-areolar scar (or "round" scar): suited to mild ptosis and areola correction.
- Vertical scar (or "lollipop"): scar around the areola and vertically down to the inframammary fold, often used for moderate ptosis.
- Anchor scar (or "inverted T"): scar around the areola, vertical and horizontal along the inframammary fold, used for marked ptosis and significant skin excess.
- Advantages and limitations: reshapes the skin and glandular tissue without adding artificial volume. Scars improve over time but remain permanent.
Mastopexy with implants (lift + breast augmentation)
- Indication: ptosis combined with volume loss or a desire for augmentation.
- Specifics: combining an implant restores volume while simultaneously correcting ptosis and augmenting the breast. The choice of implant size, shape, and positioning is personalised.
- Limitations: adds the risks associated with implants (see the risks section).
Associated fat grafting (lipofilling)
- Indication: minor volume increases or improvement of tissue quality via autologous fat transfer.
- Specifics: a natural technique using the patient's own fat. Multiple sessions may be required to achieve the desired volume.
- Limitations: limited volume and variable fat resorption.
Pre-operative Consultation
- Process: the initial consultation with the surgeon includes a medical history review (past medical history, smoking, medications, aesthetic goals), a detailed clinical breast examination (skin, volume, ptosis, asymmetries), and medical photography.
- Technical choice: the most appropriate surgical approach (type of scar, need for implants or fat grafting) is discussed and adapted to the patient's expectations and anatomical constraints.
- Additional tests: a blood panel and, depending on age or medical history, breast imaging (mammography or ultrasound) may be requested prior to surgery.
- Documents provided: written information, a detailed quote, and informed consent. The mandatory 15-day reflection period applies before any aesthetic surgery.
Procedure
- Anaesthesia: a breast lift is most often performed under general anaesthesia. Supplementary loco-regional anaesthesia may be offered.
- Duration: varies depending on the extent of the procedure and technique (generally 1.5 to 3 hours).
- Hospitalisation: day surgery (same-day discharge) or one night's hospitalisation depending on the case and post-operative monitoring required.
- General steps: pre-operative markings, incisions according to the chosen technique, reshaping of breast tissue, repositioning of the areola, possible implant placement or fat transfer, closure of incisions, and dressing.
- Safety and traceability: complete medical records, written consent, and organised post-operative follow-up.
Post-operative Recovery
- Pain and discomfort: moderate pain controlled by analgesic treatment. Feelings of tension and swelling are common in the first few days.
- Dressings and support: wearing a supportive bra day and night for several weeks, dressings, and scar follow-up.
- Rest and activities: return to work generally after 7 to 14 days depending on the nature of the job. Progressive resumption of sport and strenuous activity after 4 to 6 weeks, with medical approval.
- Monitoring: regular check-up appointments (48–72 hours, 1 week, 1 month, 3 months, 6 months, 1 year) to ensure proper healing and monitor results.
Results and Limitations
- Evolution: results are generally visible as post-operative swelling progressively subsides, then refine over several months. Scars fade over time but do not disappear completely.
- Variability: each patient evolves differently depending on age, skin quality, smoking habits, weight fluctuations, and subsequent events (pregnancy).
- Durability: mastopexy corrects ptosis, but natural ageing and weight variations may alter the appearance of the breasts over time. Medical follow-up is recommended.
Risks and Complications
- General risks: haematoma, infection, delayed healing, thrombosis, anaesthetic reaction.
- Specific risks: visible or hypertrophic scars, breast asymmetry, partial or total loss of areola sensation, rare skin necrosis, recurrence of ptosis, aesthetic imperfection possibly requiring revision.
- If implants are placed: risks of capsular contracture, implant displacement or rupture, and specific radiological monitoring.
- Information: these risks remain rare and will be detailed and explained during the pre-operative consultation.
Alternatives and Non-surgical Options
- Surgical alternatives: combination with implant augmentation, fat grafting alone for minor volume increases, or breast reduction if volume is excessive.
- Non-surgical options: supportive bras, dermatological treatments (radiofrequency, ultrasound) can slightly improve skin firmness but do not replace surgical correction in cases of significant ptosis.
- Limitations: non-invasive methods do not provide lasting lift comparable to surgical mastopexy.


