Breast Lift Sydney (Mastopexy)

Cosmetic Concerns Procedure Information Risks & Complications Procedure FAQs Procedure Pricing

Breast lift in surgery is popular for women who want to improve their overall physical appearance, including self-confidence. Breast Lift (Mastopexy) is performed to restore a more natural, aesthetic shape to the breast, as well as to elevate the nipple into a more appropriate position.

Who is ideal for breast lift surgery?

This procedure is for women who have a droop to their breasts (called breast ptosis). There are several causes for breast ptosis with the most common being breast feeding after pregnancy, weight loss, and natural process of ageing.

Breast ptosis, or sagging of the breasts, is an issue that many women will experience at some point during their lifetimes, particularly when breast feeding after pregnancy. It can also become noticeable as early as in one’s twenties and will slowly worsen over time with weight changes and the effects of aging. Regardless of the cause, it’s important for women to understand breast ptosis so they can make decisions about how best to address both its causes and any implications for their health.

There are different degrees of breast ptosis:

1 = indicates a mild degree of ptosis where the nipple sits at the fold of the breast.

2 and 3 = indicate a more severe degree of ptosis where the nipple sits below the fold of the breast.

In general women whose nipples are below the fold of the breast will always need a breast lift to achieve an aesthetic breast shape.

Some women will need the addition of implants (called augmentation-mastopexy). This is when:

They desire improved cleavage and upper pole fullness
Improve breast volume and shape after deflation post breast-feeding or weight loss
Wish to increase their cup size in addition to improving the shape OR do not want a slight reduction in size of their breast that occurs in a breast lift.
An augmentation-mastopexy can be performed as one stage, or the implants inserted at a second stage after the first procedure with mastopexy alone. For more information read our page on augmentation-mastopexy. Dr Aggarwal will guide you during the consultation if you are appropriate for a one stage procedure, or will require two stages.

Before Your Breast Lift Surgery in Sydney

Dr Aggarwal will provide you with specific instructions on how to prepare for your procedure. This includes smoking cessation at least 6 weeks (preferably more) prior to surgery, and ceasing any supplements that may predispose to bleeding (such as fish oil, Gingko, Ginseng, turmeric, circumin, garlic or herbal supplements) 1 week prior tsurgery. You should also arrange for someone to take you home after your surgery since it is performed under general anesthesia.

During Your Surgery

Breast lift procedure usually takes between two and three hours depending on the complexity of the case. You may also receive implants or fat grafting at this time if desired. The incisions will then be closed with sutures and covered with dressings or bandages as necessary.

After Your Surgery

Once your breast lift surgery is complete, you will be taken into a recovery room where medical staff will monitor your heart rate and other vital signs while you rest until you wake up from the anesthesia. Afterward, someone must drive you home – if going home the same day, you must stay with someone for the first night following your surgery in case of any complications such as bleeding or infection that require immediate medical attention.

You can expect some bruising and swelling around the incision sites which should start subsiding within ten days of the procedure; and at this time most patients are off all pain medications.

Most patients are able to resume desk type occupations after 1 week, and resume driving in the second week. A compression bra is worn for the first 6-8 weeks after surgery.

While a good idea of shape is evident at the 6-8 week mark, there can still be residual swelling after this time. The final shape is usually evident at around 3 months psot-operatively. Scars can take several months and sometimes over a year to settle post surgery. In some patients this can be longer depending on their genetic subtype and background. A breast lift is therefore an excellent procedure for patients who desire improved shape, with a trade off for scars that will fade over time.

Dr Aggarwal

Dr Aggarwal is a well regarded, respected, highly skilled and experienced Specialist Plastic Surgeon. Graduating at the top of his class throughout his training, Dr Aggarwal has completed fellowship training at some of the world’s most prestigious reconstructive and cosmetic plastic surgery institutions in Canada and the USA. He continues to publish research is prestigious plastic surgery journals, and is actively involved in the training of future plastic surgeons.

What sets Dr Aggarwal apart from others is his personal, affable and warm nature. Not only does he pay attention to detail, to producing natural, beautiful results but he ensures that the patient’s journey is just as special as their outcome. Dr Aggarwal looks after patients at one of Sydney’s most prestigious public hospital campuses (POWH/SCH/RHW), and operates privately on Sydney’s North Shore. Dr Aggarwal has treated thousands of patients throughout Sydney and beyond who have achieved outstanding results under his care.

Procedure Snapshot

Anaesthetic: GA by accredited anaesthetist
Duration of stay: Day Surgery (or overnight stay)
Medicare/Health fund rebate: There may be a health fund rebate for extreme cases of breast ptosis/droop, significantly reducing the out of pocket expenses.
Recovery: Most people can do most things at the end of the first week. Upper body exercise is disallowed for 6-8 weeks and strenuous exercise for 3 months. Avoid swimming in a pool or beach for 2 weeks.

Time: 2-3 hours
Hospital: Offered at a private hospital where Dr Aggarwal works
Results: Breast Lift Patients are some of our most satisfied patients. The scars are obvious initially as they are bright pink. However after 3-6 months they begin to settle down and fade. Similarly the shape of the breast can look odd initially, but it settles into its final shape over 3-6 months. It is important to remember this time frame and final results vary from patient to patient.

Cosmetic Concerns

“I want to avoid having the scars of a breast lift – can’t I just have implants?”

In general women with a mild droop to their breasts can get away with implants alone. A mild droop is where the nipple is at or above the fold of the breast.
If this is the case, a tear drop implant which has most of the volume at the lower pole can be effective in lifting the nipple and resembling a breast lift. Generally a larger implant may be needed.
However if your breast has a significant droop (ptosis) then breast implants alone will not achieve a lift sufficient enough to achieve the correct breast shape. In this instance the breast will look like it is falling off the front of the breast implant (also known as the waterfall deformity). A breast lift in addition to implants is necessary for these patients.

“I have saggy breasts but don’t know if I want implants”

This is a common concern for women presenting to Mode Plastic Surgery.
Breasts deflate with weight loss and also the effects of pregnancy and breastfeeding, leading to loss of volume and shape.
In general women whose nipples are below the fold of the breast will require a breast lift. Whether or not you need implants will depend on whether a breast lift alone will fulfil the volume and shape goals you are after.
It is important to remember that implants can always be inserted later, and are not without their own complications including that they need replacement every 10-15 years.
Dr Aggarwal will be able to guide you during the pre-operative consultation process as to whether you need implants are not.

“I have large saggy breasts, and wouldn’t mind reducing my cup size”

What you need is a breast reduction – the procedure is very similar to a breast lift, and the scars are also similar. However during the procedure parts of the breast tissue and fat are excised to achieve a reduction in volume and improvement in shape.
For more information please read the section of this website on Breast Reduction.

“I want the lollipop breast lift, not the anchor scar”

The decision of which scar will be employed depends on the amount of lift required and the amount of loose skin at the lower part of the breast.
Lollipop or vertical pattern for breast lifts – with this technique a certain amount of loose skin will initially be present at the lower part of the breast. This loose skin takes up over a period of 3-6 months but in some patients it does not go away completely, and may need a minor excision down the track. If this is required a small horizontal scar will be placed in the fold of the breast.
An anchor scar is necessary for patients with a large amount of loose skin as the lollipop scar will result in too much loose skin being left behind at the lower part of the breast. In massive weight loss patients, the lower part of the breast can also be used for ‘auto-augmentation’ meaning that the lower tissue is used as the body’s own implant for volume enhancement and better breast shape.
Dr Aggarwal will be able to guide you during the pre-operative consultation process as to which scar will be best for your breast lift.

Procedure Information

The procedure is always performed under general anaesthesia given by an accredited anaesthetist in a fully accredited and licensed facility (usually one of the North Shore’s premier private hospitals). The procedure takes two-three hours and most patients will be discharged the same day (some stay overnight however).

Mammogram and Ultrasound

Before any surgery on your breast Dr Aggarwal will refer you for a mammogram and ultrasound to ensure the breast is clear of any pathology.

Incisions

A scar has to be placed all the way around the nipple and areola to achieve a breast lift. In general the scars can be of three different types as listed below.

Peri-areolar

This scar is just around the nipple and areola
It allows the areola to be reduced in size and while also allowing a lift to be performed

This scar has the advantage of:

avoiding the vertical or horizontal scars
good for patients who need minimal lift of the nipple
in tuberous breast (or snoopy/constricted breast) deformity this is used to reshape and redrape breast tissue over an underlying implant

However this scar has some disadvantages

The nipple and areola can expand over time
The scar can heal asymmetrically

Lollipop (Vertical Breast Lift Scar)

This incision is placed around the nipple and areola, as well as vertically down from the areola to the fold of the breast
This is the most common incision used by Dr Aggarwal for mastopexy

The advantage of this scar are:

Allows excellent shaping of the breast, with the vertical scar allowing removal of excess skin on the breast, and allowing the breast to become more ‘perky’
Allows resizing the areola to a more appropriate size
The vertical scar takes tension off the nipple and areola reducing the chances of it widening over time

The disadvantages are few but include:

An extra scar compared to the periareolar. In general, we find that this scar heals very well becoming inconspicuous over time.
There can also be some redundant loose skin left at the inferior part of the breast – this takes up over the first few months and rarely needs a small revision. If it needs to be excised the scar is often shorter than it would have been had it been removed at the time of the original operation.

Anchor scar (Wise pattern Breast Lift Scar)

This incision is placed around the nipple and areola, as well as vertically down from the areola to the fold of the breast, and a horizontal incision in the fold of the breast.

The advantage of this scar are:

Allows excellent shaping of the breast, with the vertical and horizontal scars allowing removal of excess skin on the breast, and allowing the breast to become more ‘perky’
Allows resizing the areola to a more appropriate size
The vertical scar takes tension off the nipple and areola reducing the chances of it widening over time

The disadvantages are few but mainly that there are extra scars compared to the periareolar and lollipop approaches. In general, we find that these scars heal well become more inconspicuous over time. Due to the T shaped scar, sometimes there is slower healing at the T junction.

Drains

In general drains are avoided during a mastopexy procedure allowing patients to go home the same day (or the next).
The exceptions are
- Patients also having removal of old implants and capsulectomy (removal of the layer of tissue surrounding the implants)
- Patients on blood thinning medications
- If unexpected bleeding or alternative situation that could increase the risk of seroma (fluid collection) is found during the operation.
If a drain is inserted you may need to stay in hospital overnight, or alternatively go home with the drain and see Dr Aggarwal or his staff a few days later in the rooms.

After your breast lift (mastopexy) surgery

Dr Aggarwal will place waterproof dressings over the incisions.
You should wear a compressive sports bra or crop top for the first 6-8 weeks. This helps to reduce swelling, pain and discomfort in the early post-operative period as the area heals.
You will be able to get the area wet after 72 hours and go back into your compression bra after your shower. You will not be allowed to swim in a pool or beach for at least 2 weeks after surgery. This could be a little longer is there are wounds that are slower to heal.
You will be given a script for antibiotics by Dr Aggarwal which you must continue until the box runs out
You will also be given pain relief medications although most patients only report minor amounts of post-operative pain that is responsive to simple oral analgesia.
You will not be allowed to go back home on your own – you must have someone accompany you home, and it is best to have someone look after you for the first few days as you recover. You should not drive for at least 24 hours after having an anaesthetic and usually not drive in the first week after breast surgery.
While most sedentary activities can be resumed in the first week, you must not do any exercise for the first few days after surgery that could raise your blood pressure. You will also not be allowed to do any heavy lifting or upper body exercises for the first 6-8 weeks.
Dr Aggarwal will see you a week after your procedure to inspect how the wound is healing. You will be given instructions how to look after the wound as it continues to heal. You will be able to ask questions about what you can and cannot do. Generally we will see you at 1 week, 3 weeks, 6 weeks, 3 month, 6 months and 1 year post surgery.

Risks & Complications

Every surgery carries risks, and therefore one must consider if risks outweigh the benefits for your own personal situation. If they do then the surgery may be well worth it. Dr Aggarwal will discuss the pros and cons of surgery with you during your consultation.

General Complications

Risks of anaesthetic – there are general risks of going under an anaesthetic such as a mild stress on the heart and lungs, risk of reaction to anaesthetic drugs and risk of clotting in the legs. These risks are generally low in patients who are otherwise fit and healthy.
Bleeding (1-2%) – any bleeding is controlled during surgery however unexpected bleeding can occur in the immediate postoperative period. If this occurs it will necessitate a return to theatre to control the bleeding.
Infection (<1%) – this is very rare. However you are given antibiotics during induction (when you are going to sleep), as well as a course of oral antibiotics after your surgery to keep this risk to a minimum.
Poor Wound Healing (5%) – Occasionally absorbable sutures used under the skin can be rejected by the body forming a small pustule where the suture spits out. These issues usually resolve with removing the suture and dressings.

Specific Complications

Nipple compromise – this is a rare but most significant complication in a breast mastopexy or reduction procedure. When the breast is reshaped the aim is to keep a block of breast tissue behind the nipple intact. This block of breast tissue contains the blood supply that keeps the nipple alive as well as the nerves that supply sensation to the nipple.
- There can be problems with the blood supply of the nipple, more so if a reduction is being performed than mastopexy, and if there has been previous surgery to the breast.
- Arterial problem – this is when there is a problem with the blood coming to the nipple and it therefore turns white. This may require the nipple to be removed and placed back as a nipple graft.
- Venous problem – this is where there is a problem with the blood returning to the body from the nipple. It gets to the nipple, and pools there therefore turning the nipple blue. This may require manoeuvres to reduce the tension on the nipple, and sometimes other adjunctive techniques to increase the blood draining from the nipple.
Change in nipple sensation – a third of women preoperatively have reduced sensation to their nipples, a third have normal sensation and a third have more than normal sensation (hypersensitivity). Literature indicates that these ratios are unchanged following breast lift/reduction surgery.
- However we believe that it is possible to reduce the sensation to the nipple following any breast surgery.
- In most cases this should be transient and returns to normal, a process that takes up to 12 months.
Change in the ability to lactate or breast feed: a third of normal women (who have not had surgery) have normal ability to breast feed, a third have reduced capacity (i.e. will need to supplement their feeds with formula to their infant), and a third have no capacity to breast feed. Literature indicates that these ratios are unchanged following breast lift/reduction surgery.
- However we believe that it is possible to reduce the ability to breast feed following any breast surgery.
- If this is of great significance to you, you should either not have breast lift/reduction surgery or postpone it to when you have completed having your family.
Widening of the nipple-areola complex – this can be a problem with a periareolar mastopexy. The most effective way of preventing this complication is to place a vertical scar in addition to the scar around the nipple (lollipop) which takes the tension off the nipple and areola.
Hypertrophic or poor scars – How one’s body behaves to scarring is individual and largely genetic. Some types of skin are more prone to hypertrophic or keloid scarring, and some individuals and families are more prone to this. We will routinely advise you on how to improve the quality of scars over time. You should also discuss any history of abnormal scarring with Dr Aggarwal preoperatively.
Asymmetrical nipple position, shape and scars – due to scars on the breast, and native asymmetry of every woman’s breasts there can be a difference in how each breast behaves to the surgery, and this can produce an asymmetry to the nipple size and shape or the scars in general, albeit the aim is to get them as symmetrical as possible.
Nipples too high or too low – in general at the end of a mastopexy procedure the aim will always be to have the nipples sit a little low. This is because as the breast settles, and scars relax the nipples will move up. The aim is to avoid the nipples looking too high as this can be an extremely difficult problem to correct.
Unusual breast shape – it is common for the initial shape of the breast to be unusual as lower part of the breast gland and skin is tightened making the upper part look fuller and the lower part look tight. This settles as the scars relax and the breast settles. This can take approximately 3 to 6 months.
Asymmetry
- Most women’s breasts are asymmetrical
- The aim during mastopexy is to get them more symmetrical – if required this may involve a small amount of tissue excision on one or both sides
- This process is not entirely predictable and there can be small asymmetries in the final breast shape.

Procedure FAQs

Do I need a referral for breast lift/reduction?

It is now compulsory to obtain a GP referral for all plastic surgery consultations.
It is also possible that a Medicare/Health Fund rebate may apply to you depending on what procedure you need, and having a referral allows you to claim this reducing out of pocket costs substantially.

Where can I see Dr Aggarwal?

You can see us at our main practice at Gordon, or at our other locations at Hornsby, Hunters Hill, Potts Point or Camperdown.
Please scroll to the bottom of the page to find out more information about these locations.

Where will I have my operation?

Any of the hospitals where Dr Aggarwal works – i.e. Sydney Adventist Hospital, SAN Day Surgery or Hunters Hill Private.

What can I do to prepare for surgery?

Cease fish oil, and other supplements such as Ginkgo, Ginseng, turmeric, circumin, garlic and herbal supplements.
Please discuss with Dr Aggarwal if you are on blood thinning medications as to when you should stop and recommence those.

After surgery, will I need to wear a special surgical bra?

Yes we will provide you with a surgical compression bra during surgery as well as a spare to allow one to be in the wash. You need to wear these bras for the first 8 weeks after surgery.
You should not wear any bras with an underwire during this period

Will I be able to exercise after surgery?

You should not do any exercise that raises your blood pressure for at least 72 hours after surgery to avoid the risk of an unexpected bleed
Heavy upper body exercise should be avoided for 6-8 weeks

Will I need special medications after surgery?

Dr Aggarwal will provide you with the necessary scripts for antibiotics and pain relief.

Will I need further surgery?

Not usually.
Most patients are extremely satisfied following breast lift surgery and will not require any additional surgery.
Sometimes a breast augmentation is performed as a second stage procedure, and this is usually done at least 3 months after breast lift (mastopexy)

Can I travel in an airplane after surgery?

Yes
However we always encourage patients not to be away overseas shortly after having a procedure, so that we can closely follow your recovery and address any concerns that may arise.

When will I be able to swim after breast lift/reduction?

You may swim in a pool or beach after 2 weeks as this is the time it takes for the incision to heal.

When will I be able to drive after breast lift/reduction?

It is best to not drive for the first 1 week after surgery.

Do you offer local anaesthetic or sedation for breast lift?

It depends on what surgery you require.
The vast majority of patients will require a general anaesthetic in an accredited private hospital.
It is usually a day surgery procedure but you will need someone to pick you up and accompany you home after the procedure
Minor breast lifts that involve minimal removal of skin can be undertaken under local anaesthetic in the rooms. This applies to only a small percentage of patients.

Will breast lift/reduction change the sensation of my breasts?

A third of women preoperatively have reduced sensation to their nipples, a third have normal sensation and a third have more than normal sensation (hypersensitivity). Literature indicates that these ratios are unchanged following breast lift/reduction surgery.
However we believe that it is possible to reduce the sensation to the nipple following any breast surgery. In most cases this should be transient and returns to normal, a process that takes up to 12 months.
Permanent loss of sensation to the nipple is rare.
If this is of significant concern to you, you should not have surgery on your breast.

Can I breastfeed after breast lift/reduction?

Even in the normal population (women who have not had breast surgery) up to a third of women cannot breast feed at all, and a third require additional supplementation for their infant. The remaining third of women can breast feed normally. These proportions of women are unchanged after breast lift/reduction surgery.
- However we believe that it is possible to reduce the ability to breast feed following any breast surgery.
- If this is of great significance to you, you should either not have breast lift/reduction surgery or postpone it to when you have completed having your family.

Can I have imaging for breast cancer screening after having breast lift/reduction?

Yes
However the additional scarring within the breast can make breast mammogram and ultrasound more difficult to interpret by radiologists.
It is therefore important that prior to undergoing surgery you have imaging of the breast – it makes sure there is nothing of concern in the breast tissue, and also forms a baseline against which a post-surgery mammogram can be compared.
It is important for you to participate in regular screening as you would have otherwise done for breast cancer based on your age and family history, after having surgery

Can breast lift/reduction cause cancer?

No.
However any tissue removed during surgery is sent for histopathological examination meaning it is examined by experts under a microscope. This is to ensure there is no evidence of suspicious pathology in that tissue.
Despite having preoperative imaging, it is possible for an occult breast cancer to be detected by having surgery. The rate of this is 0.3%.
It is important for you to participate in regular screening as you would have otherwise done for breast cancer based on your age and family history, after having surgery
In Australia it is recommended for women who reach the age of 50 to undergo 2^nd yearly mammography for breast cancer screening in the absence of other significant family history – if you have a strong family history you may be required to start breast cancer screening earlier

Are there any alternatives to breast lift/reduction?

In general women with a mild droop to their breasts can get away with implants alone. A mild droop is where the nipple is at or above the fold of the breast.
If this is the case, a tear drop implant which has most of the volume at the lower pole can be effective in lifting the nipple and resembling a breast lift. Generally a larger implant may be needed.
However if your breast has a significant droop (ptosis) then breast implants alone will not achieve a lift sufficient enough to achieve the correct breast shape. In this instance the breast will look like it is falling off the front of the breast implant (also known as the waterfall deformity). A breast lift alone, or in addition to implants is necessary for these patients.

Procedure Pricing

A quote for this procedure will be provided to you after a consultation with Dr. Aggarwal. You can also call or email our office for our current indicative pricing.
If a Medicare item number applies to your surgery (45558), and you have appropriate health insurance cover, the out of pocket cost could be reduced.
Please note that the above price does not include
- Preoperative consultation fees
- Breast implants if you desire augmentation-mastopexy (see our website section on this procedure for more details)

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