A reconstructive surgical procedure in which sagging breast tissue and the nipple are repositioned due to tissue laxity caused by pregnancy, breastfeeding, or aging.
Indication
- Persistent sagging (ptosis) of breast tissue after pregnancy and breastfeeding
- Loss of breast skin elasticity and tissue support due to significant weight loss
- Positioning of the nipple below the inframammary fold (advanced ptosis)
- Chronic inframammary intertrigo (skin fold irritation) and eczema due to sagging
- Asymmetric breast ptosis (significant sagging on one side)
- Developmental breast shape disorders such as tuberous breast deformity
- Cases planned together with breast reduction or reconstruction
Preparation
- Detailed breast examination, measurements, and ptosis grading (Regnault classification)
- Mammography and breast ultrasound in patients over 40 or in risk groups
- Smoking is stopped 2 weeks before the procedure (critical for skin healing)
- Blood thinning medications are discontinued with physician approval
- Fasting for 8 hours before surgery
How it's performed
- Performed under general anesthesia
- The skin incision pattern is determined according to the degree of sagging (around the areola, vertical, inverted T)
- Excess skin is removed and the breast tissue is reshaped
- The nipple and areola are moved upward while preserving blood circulation
- Skin layers are closed with absorbable sutures
- Procedure is completed with a drainage catheter and supportive bra
Post-procedure
- Same-day or 1-day hospital stay
- Use of a supportive surgical bra for the first 4-6 weeks
- Avoid heavy lifting and over-the-head arm movements for the first 2 weeks
- Return to normal activity after 4-6 weeks; sports after 6-8 weeks
- Scar maturation takes 12-18 months; sun protection during this period
Risks
- Wound healing problems, hypertrophic or keloid scarring
- Temporary or permanent decrease in nipple sensation
- Asymmetry and need for revision surgery (approximately 5-10%)
- Hematoma, seroma, infection
- Risk of limited breastfeeding function
- Anesthesia reactions
FAQ
Is mastopexy covered by health insurance?
Standard mastopexy is generally not covered. When significant functional problems (chronic intertrigo, back-neck pain) are documented, coverage may be considered in cases combined with reduction; the decision rests with the payer institution.
Will a future pregnancy affect the result of mastopexy?
A subsequent pregnancy and breastfeeding may change breast tissue again; ptosis may recur after mastopexy. For this reason, it is recommended to consider the procedure after pregnancy plans are completed.
Is breastfeeding possible?
Although techniques that preserve the milk ducts are preferred, breastfeeding capacity may be reduced in some cases. Future breastfeeding plans must be discussed before surgery.
When can I return to work?
Returning to desk work after 7-10 days and to physically demanding occupations after 4-6 weeks is generally appropriate.
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