Mastopexy: a means to correct breast ptosis

The demand for aesthetic surgeries and procedures is at an all-time high, and with the persistent and significant influence of social media, is likely to continue rising. In its most recent global survey, the International Society of Aesthetic Plastic Surgery (ISAPS) announced an 19.3% overall increase in procedures performed by plastic surgeons in 2021, with more than 12.8 million surgical, and 17.5 million non-surgical, procedures performed worldwide (ISAPS, 2023). Of these, breast surgeries in both men and women were some of the most frequently performed, with breast augmentation and gynecomastia (i.e., overdevelopment of breast tissues in males) correction being the most prevalent. However, mastopexy—more commonly known as a ‘breast lift’—was revealed to be the fifth most common surgical procedure for women, with a remarkable 31.4% increase in occurrence noted between 2020 and 2021 (ISAPS, 2023).

Mastopexies are usually performed to address breast ptosis (i.e., sagging or unevenness), whether that be due to post-partum milk gland diminishment or volume loss following menopause or massive weight loss. Ptosis can also be congenital or acquired—the first being caused by a variety of genetic factors, and the latter the result of mastectomy. Breast ptosis can pose a significant psychological burden to patients: Ibrahim et al (2015) determined the burden of living with breast ptosis requiring surgical intervention, demonstrating that the health burden of living with breast ptosis was comparable with that of breast hypertrophy, uni- and bilateral mastectomy, and cleft lip and palate. Furthermore, given the option to undergo mastopexy as a means to treat breast ptosis, Ibrahim et al's (2015) study population reported being willing to risk a hypothetical 10% chance of death and trade 4.6 years of life. Therefore, careful selection of the correct mastopexy technique and developing optimal pre- and post-intervention care, incorporating psychological input and perioperative management of patient expectations, is critical to address the psychosocial impact, alongside the physical manifestations, of breast ptosis.