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    Breast lift

    Reasons for a breast lift?

    Pregnancy and breastfeeding periods, weight fluctuations and tissue changes after menopause are considered the main causes of breast sagging. Many women find sagging breasts unsightly and distressing and use special support bras or a sports bra, but this provides only limited relief.

    In addition to aesthetic reasons, there is evidence that sagging breasts promote back pain [1]. First and foremost, sufferers want more beautiful, firmer breasts, but tightening to beautify the breasts can also promote an increase in physical performance, improved self-esteem, and a higher quality of life [2]. Over 90 percent of patients are very satisfied with the results of a breast lift.

    For further information on the aesthetic surgical treatment of a so-called trunk breast, please visit the page tubular breasts in the category breast malformations.

    At what age breast lift?

    On average, patients who undergo breast lift surgery are 45 years old [3]). However, as described above, the natural aging process is not the only cause of sagging breasts. There are also many younger patients who desire a better body image after severe weight loss and thus consider surgical intervention. If the breasts are sagging after a pregnancy and weaning strongly depend, we recommend to wait not only a few weeks, but 6 months. Take advantage of a no-obligation online video consultation or, best of all, make an appointment for an on-site examination so that your individual wishes can be analyzed in consideration of your physical conditions. You can find more information about breast surgery after childbirth in advance on our Breast Surgery FAQ page under the heading “When can breast surgery be performed after pregnancy?” There you will also find the answer to many other frequently asked questions.

    Are there alternatives to breast lift?

    There are a variety of treatment approaches to stop skin aging or help skin regain a youthful tone. Skin creams can be used as a preventive measure. Microneedling or Sculptra® treatment stimulates collagen production and improves skin elasticity. Stretch marks on the breast can be effectively mitigated with these treatments. Other treatment methods such as thread lifting, radio frequency (Cutera®), ultrasound (Ultherapy®) or laser treatment are not suitable for tightening a breast. You can find out more in our “Skin and hair” section.

    What is a breast lift?

    Lifting surgery, whether on the breasts or abdomen, removes sagging, overstretched skin and fulfills the desire to restore a youthful and attractive appearance to the body. Techniques have continued to evolve over many decades to achieve a natural and youthful breast shape while leaving nearly invisible scars. For an optimal final result, many characteristics of the breast must be taken into account:

    • The breast fullness and size should harmonize with the body silhouette.
    • The breast silhouette should form a gentle, inward curve in the upper part and a harmonious curve in the lower part.
    • The nipple should be at about the highest point of the breast. This point is ideally located at the level of the middle of the upper arm.
    • The distance of the nipple to the inner boundary of the breast in relation to the outer boundary is ideally 60 to 40 percent [4].
    • A volume ratio of the upper and lower half of the breast of 45 to 55 percent is considered most harmonious [5].

    What methods or types of breast lift are there?

    Each treatment or surgical method has specific advantages and disadvantages. The key to a perfect result is to choose the treatment option that best suits the individual shape and size of your breasts. The recommendation of a particular technique is primarily based on the conditions of the breasts, mammary gland tissue and skin. Your goals, health status, previous treatments and current scientific findings will also be taken into consideration in order to select the most appropriate breast lift method with you. The different methods of skin tightening on the breast are schematically divided according to the course of your scars:

    O Engineering:

    Surgical methods that leave a scar around the areola are commonly referred to as O technique. These methods can remove a slight excess of skin, no more than two centimeters in diameter. The technique was already described in 1932 [6]. Plastic surgeon Louis Benelli added a special suturing technique around the nipple to the method to avoid enlargement or deformation of the areola [7]. This technique is therefore often sought under the name Benelli method. However, this technique is not suitable for breast reduction.

    I Engineering:

    The term I technique is used to describe various methods that leave a circular scar around the nipple and a vertical scar between the nipple and the inframammary fold. Due to the shape of the scar, which extends mainly over the lower chest area, it is also called the lollipop technique. The “I” technique offers the advantage that the scar is smaller than with the T technique. It is therefore also referred to as the short-scar technique. The I-cut technique of breast reduction with a vertical “I” shaped scar was described as early as 1923 [8]. The French plastic surgeon Claude Lassus further developed the surgical technique in the seventies. In the technique, the nipple remains in union with an upper tissue bridge [9]. For this reason it is also known as the Lejour method. Hall Findlay has described a slight variation of the Lejour technique, using a pivoting motion to offset the nipple for the new position [10]. The disadvantage of this technique is that the breast takes on a funnel shape after the operation. It can take up to six months for the breast to take on a natural drop shape after surgery. In the case of a breast reduction of more than 500g, there is also the risk that the vertical scar below the underbust fold will become visible and that excess skin will remain as a skin peak.

    J or L technique:

    In the J-method or L-method, excess skin is removed from the lateral chest in addition to the I-technique. The remaining J-shaped or L-shaped scar therefore looks like the letter J on the right breast, or like the letter L on the left breast due to the L-cut.

    T Engineering:

    In contrast to the I technique, the T method also involves a horizontal tightening of the skin. The tightening in vertical and horizontal alignment allows a precise shaping of the breast. The technique leaves a T-shaped scar, similar to the I technique, with the shortest possible scar hidden in the underbust crease. The scar in the T incision has the shape of an anchor or an inverted T. The upper part of the “T” forms the lower part of the scar due to the horizontal cut. The technique was already described by Erich Lexer in 1912 [11]. In the USA the technique is called “Wise pattern” [12]. This method is especially appropriate for large breasts and inelastic skin.

    1 Nourishing arterial branches of the nipple (branches of the lateral thoracic artery) 2 Nourishing arterial branches of the nipple (branches of the internal mammary artery, also called internal thoracic artery) 3 Upper tissue bridge of the nipple 4 Fifth rib 5 Tightened breast after the T-technique with fine inconspicuous intracutaneous sutures 6 Lower tissue bridge of the nipple

    What is the technique of the inner bra?

    During a breast lift, the nipple is returned to its original position and excess skin is removed. In order to give the breast tissue more support and the breast more fullness, various techniques have been described in which deeper skin layers and fatty tissue of the breast are moved. Since the first description of the internal bra technique in 1978, many variations have been added [13]. Research suggests that the inner bra technique helps the lower half of the breast to be more supported [14].

    1 Lower tissue shaft 2 Tightened breast according to the T-technique with fine inconspicuous intracutaneous sutures 3 Lower tissue shaft, so-called inner bra 

    Does the combination of breast lift and breast augmentation make sense?

    Patients with sagging breasts often wear larger bras than necessary due to the sagging skin. Depending on the size of the breast, the excess skin removed can weigh 80 to 150 grams. Therefore, a breast lift alone may decrease the bra size by one cup [15]. If a fuller décolleté is desired, we therefore recommend the simultaneous performance of an autologous fat treatment of the breast. You can find out more on our page Breast augmentation with autologous fat. For patients who wish to have their breasts enlarged by more than one cup size, we recommend a breast lift with enlargement by means of an implant. You can find out more about this on our page Breast augmentation with implant.

    How long do the results of a breast lift last? Is it permanent?

    In the course of wound and scar healing after the operation, the tissue between the nipple and the underbust fold lowers a little. These changes are already planned by experienced experts in aesthetic plastic surgery during the operation. In the first months, the breasts may therefore have a slightly pointed shape. Approximately after the third month, the final shape becomes apparent. A permanent result is achieved at the latest one year after the operation. Research shows that results do not change for 10 years afterwards [16].

    Breast lift procedure

    The surgical duration of a breast lift is 1.5 hours for smaller breasts and up to 4 hours for very voluminous breasts. This generally depends on the extent of the intervention.

    A tightening of the female breast can be carried out gently and with particularly little pain in so-called twilight sleep. Fast Recovery Anesthesia has been used in the CenterPlast practice for years with good success. Your safety and comfort are paramount with this method. Due to the targeted long-acting anaesthesia of the nerves of the chest wall, only little anaesthetic is necessary. This form of anaesthesia is considered to be less risky than general anaesthesia. In addition, our patients recover very quickly after surgery and require less medication for pain even hours after surgery.

    Comprehensive information and the best possible preparation will help you to overcome your nervousness in the run-up to cosmetic surgery. The individual steps will be discussed again with your aesthetic plastic surgeon. The surgical plan is then drawn on the skin of your breasts with a special pen. Shortly afterwards, the anaesthetist will greet you. Attentiveness and personal care ensure a pleasant atmosphere. As a preventive measure, you will be given an antibiotic before you are received in the operating room. Before the start of each operation, the surgical team routinely discusses all important points again. Only when everything has been checked will the anaesthetist give you a painkiller so that you do not even feel the anaesthetic injections. Usually, the patients are already in a light sleep while the entire surgical team is concentrating on the procedure.

    After completion of the plastic-aesthetic procedure, a bandage will be applied. The surgical team will help you put on the special compression bra. This special bra (also called a support bra) must be worn for the first few weeks after the surgery. If you wish, the attending physician will contact a relative immediately after the operation. You will be able to drink or eat something shortly after the operation. Before you are collected, your surgeon will discuss with you once again what needs to be taken into account. You will receive a letter in which all recommendations, follow-up appointments and the personal telephone number of your surgeon are listed.

    Are drains placed during a breast lift?

    Wound fluid that accumulates in a cavity can cause a feeling of tension and promote the development of inflammation. To prevent wound fluid from accumulating, drains drain the fluid from the wound. Through a gentle tumescent technique and the use of high-frequency surgery, the risks of haematoma are reduced. Nevertheless, concomitant diseases, physical exertion or certain lifestyle habits can interfere with wound healing and lead to an accumulation of wound water. Occasionally, risks for developing bruises can go undetected despite the best preparation and a targeted blood test. If increased risks become apparent before an operation or if an increased tendency to bleed becomes apparent during the operation, drains are placed. In most cases we are able to do without drainage.

    What are the risks of a breast lift?

    In general, there is a high level of patient satisfaction after breast lifts. Complication rates are relatively low on average [17]. The most common possible risks include scar discomfort or changes in nipple shape. Even though perfect symmetry is always the goal, in certain cases lateral imbalances cannot be corrected completely. General surgical risks include secondary bleeding, wound water accumulation, inflammation, and wound healing problems. The extent of the procedure as well as the patient’s age and state of health affect surgical risks. On average, a breast lift has fewer complications than combining a lift with breast augmentation with implants. The risks or possible complications are generally lower in healthy non-smokers than in patients with concomitant diseases who smoke or have smoked.

    Behavioural recommendations before and after a breast lift

    What should be considered before and after a breast lift? External pressure on the tissue impairs wound healing. Therefore, sleep on your back or side for the first six weeks after a breast lift. A special support bra promotes the healing process by removing tension from the wound. Please note the general recommendations for behaviour after breast surgery on the Breast Surgery FAQ page. There you will find out how to prepare for breast surgery and what other aftercare measures should be taken into account. Among other things, it also discusses when sports and a return to work are allowed and how to take optimal care so that visible scars are reduced.

    Before and after pictures of a breast lift at CenterPlast Saarbrücken

    Before and after photos may not be published on the internet according to § 1 paragraph 1 No. 2 of the Heilmittelwerbegesetz. However, within the framework of a breast lift consultation, it is possible to explain the desired result in the first consultation and, if there is serious interest, to view selected photos for which patients have given their consent in advance. This is done in compliance with data protection. The photographs allow you to get an idea of your “new breast”. This will allow you to realistically assess the possibilities and limitations of cosmetic surgery. For more information, please visit our before and after pictures page in the “About Us” menu category in the “Quality” section.

    Why a breast lift at CenterPlast ?

    CenterPlast stands for competence – safety and comfort. You can get advice from a surgeon as well as a female surgeon. In any case, the highly trained and experienced doctors will take care of your personal concerns. Since the quality of our treatment is our guiding principle, we provide more detailed information about quality in plastic surgery under “What is quality?”. There you will learn in more detail about the specific competencies that distinguish our experienced specialists.

    Dr. Santos Stahl learned breast cosmetic surgery in Brazil and successfully passed the Brazilian, German and European examinations to become a specialist in plastic and aesthetic surgery. Plastic surgeons from all over the world travel to Brazil to learn the modern techniques and dexterity of Brazilian surgeons in the field of aesthetic surgery of the breast. In order to expand her knowledge, Dr. Santos Stahl has also worked with renowned surgeons in Germany and the USA. Internationally recognized Brazilian surgeons include:

    Ribeiro L. (A new technique for reduction mammaplasty. Plast Reconstr Surg. 1975 Mar;55(3):330-4).

    Goes JCS. (Periareolar mammaplasty: Double skin technique. Rev Soc Bras Cir Plast 4:55-63, 1989).

    PD Dr. Stahl has acquired his expertise in the field of breast surgery in Germany and the USA. Due to his surgical training, he is not only extremely attentive to detail but also very sensitive. As a scientist, he knows that progress requires critical questioning. PD Dr. Stahl maintains a constant exchange with international scientists and experts in the field of plastic surgery in order to provide you with an edge through knowledge at all times.

    Experience reports of a breast lift at CenterPlast Saarbrücken.

    Visit our testimonials page in the “About Us” menu category to read patient testimonials. There they report, among other things, on their satisfaction with the surgical result, the way they were treated by the team and whether they would recommend the practice to others.

    We generally encourage our patients to rate us on Jameda and Google so that other patients can get an idea of what to expect during a consultation and procedure at CenterPlast. In fact, many patients are willing to share their “breast lift experiences” with other sufferers to help you make the right decision. During the individual consultation, we can also put you in touch with patients who agree to a personal report and answer your questions.

    What are the costs of a breast lift?

    Would you like to know the price of breast lift surgery? What a breast lift will cost cannot be determined across the board without an examination. This requires a personal consultation. If you would like to get an overview of the price framework before such a detailed consultation, it is best to take a look at our cost page.

    When does health insurance pay for a breast lift?

    When it comes to the topic of breast lift and thus the correction of sagging breasts, it must be taken into account that this is an aesthetic operation. The costs of such cosmetic surgery are not covered by health insurance. To learn how you can finance sagging breasts correction, visit our cosmetic surgery financing options page.

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    The author

    Dr. med. Stéphane Stahl

    “We provide you with extensive expert knowledge so that we can work with you to select the best possible treatment path.”

    Dr. med. Stéphane steel is the former director of the Clinic for Plastic, Reconstructive and Aesthetic Surgery / Hand Surgery at the Lüdenscheid Clinic. Dr. Stahl studied medicine at the Universities of Freiburg and Berlin. In 2011 he passed the European and 2012 the German specialist examination for plastic and aesthetic surgery. Further specialist qualifications and additional qualifications followed (including quality management, medical didactics, physical therapy, emergency medicine, laser protection officers, hand surgery) as well as prizes and awards. In 2015 he completed his habilitation in plastic and aesthetic surgery in Tübingen. He is an experienced microsurgeon, a sought-after expert and a regular speaker at specialist congresses. After a multi-stage selection process, Stéphane Stahl became a member of the American Society for Aesthetic Plastic Surgery (ASAPS), one of the world’s largest and most influential specialist societies for aesthetic surgery. His authorship includes numerous articles in respected peer review journals and standard surgical textbooks.

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