Medical Encyclopaedia › Mastopexy (short definition)
In brief: In a breast lift (mastopexy), a sagging breast is surgically lifted and reshaped. Excess skin is removed, the glandular tissue is positioned higher and the nipple with the areola is moved upwards. Breast volume hardly changes; if the breast is also to become larger or smaller, the lift is combined with augmentation or reduction. Scars are unavoidable.
When may a breast lift be considered?
Over time, the breast loses firmness. Pregnancies and breastfeeding, marked weight fluctuations, natural ageing, gravity and genetically soft skin contribute to this. Typical signs are a nipple lying at or below the level of the inframammary fold, a downward-pointing areola and an empty-looking upper part of the breast. A breast lift is an aesthetic decision and is generally not medically necessary. Favourable prerequisites are a stable body weight, completed family planning, not smoking and unremarkable breast cancer screening. Depending on age and risk, an ultrasound examination or mammogram is recommended before the operation.
Techniques and scars
The choice of method depends on how much the breast sags and how much skin needs to be removed:
- Periareolar technique: an incision around the areola, for minor findings; the scar lies at the edge of the areola, but the areola may widen.
- Vertical technique: additionally a vertical incision from the areola to the inframammary fold; often used for moderate findings.
- T-incision (anchor incision): additionally a scar in the inframammary fold, for pronounced excess skin.
If the breast lacks volume, an implant or the patient’s own fat can be inserted. Combining a lift with an implant is technically more demanding and, in studies, is associated with a higher rate of corrective operations than either procedure alone; some surgeons therefore perform the two steps separately. The operation is performed under general anaesthesia and usually takes two to three hours.
Healing and course
After the procedure, a well-fitting support bra is worn for several weeks. Swelling, a feeling of tightness and bruising subside in the first weeks; the final shape only develops after a few months, because the tissue is still settling. Physically light work is often possible after one to two weeks, sport and heavy lifting only after several weeks and medical clearance. The scars are red at first and usually fade within one to two years, but remain visible. How long the result lasts depends on tissue quality, weight changes and further pregnancies; the breast may sag again over time.
Risks and complications
- wound-healing problems, especially where the incisions meet in the T-incision; much more common in smokers
- secondary bleeding, bruising, infections, seromas
- widened, red or raised scars, up to keloids
- altered, reduced or, rarely, increased sensitivity of the nipples
- circulatory disorders of the areola up to partial tissue loss, rarely
- asymmetries, shape irregularities and corrective procedures
- restricted ability to breastfeed, because milk ducts may be severed
- with additional implants, the typical implant risks such as capsular contracture
As with any operation under general anaesthesia, there is a small risk of thrombosis and anaesthetic complications.
Costs and health insurance
A breast lift for aesthetic reasons is paid for privately. German statutory health insurers only cover the costs in exceptional cases, for example in pronounced malformations or to match the healthy side as part of breast reconstruction after cancer; an application must be made in advance. If complications occur after an aesthetic procedure, the insurer can require insured persons to share the treatment costs under Section 52 SGB V. A written cost estimate and clarity about possible follow-up costs are therefore advisable.
Important to know
Before deciding, there should be a detailed consultation with a specialist in plastic and aesthetic surgery and sufficient time to reflect. This includes questions about scar position, the wish to breastfeed, durability of the result and the procedure in the event of complications. Breast cancer screening remains possible after the operation; scars and tissue changes should be reported to the radiologist. Alternatives are well-fitting bras, augmentation alone in the case of volume loss without marked excess skin, or deliberately waiting until after pregnancies.
Related terms in the encyclopaedia
Augmentation mammoplasty, Capsular contracture, Breast reduction, Lipofilling, Scar, Keloid, Breastfeeding, Mammography, Seroma
Sources
- Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC): Patienteninformationen zur Bruststraffung
- American Society of Plastic Surgeons (ASPS): Breast Lift (Mastopexy) – Patient Information
- AWMF-S3-Leitlinie Prophylaxe der venösen Thromboembolie (VTE)
- Sozialgesetzbuch Fünftes Buch (SGB V), § 52 Leistungsbeschränkung bei Selbstverschulden
Note: This article is for general information and does not replace advice, diagnosis or treatment from a doctor, dentist or pharmacist. Last updated: October 2026.