Breast Lift Surgery (Mastopexy) in Singapore
A breast lift, or mastopexy, is a surgical procedure that reshapes and elevates sagging breasts by removing excess skin, tightening the surrounding tissue, and repositioning the nipple and areola higher on the chest wall. It restores shape and position without changing the size of the breast.
At Argent Plastic Surgery, mastopexy is performed by Dr Lee Hanjing, a fellowship-trained plastic surgeon, at Mount Alvernia Hospital. Whether surgery is right for you depends on the degree of sagging present, your anatomy, and what you would like to change.
What Is a Breast Lift (Mastopexy)?
A breast lift is a surgical procedure designed to correct breast ptosis, the clinical term for sagging. Also known as mastopexy, the procedure removes excess skin, tightens the tissue envelope around the breast, and repositions the nipple and areola to sit higher on the chest. The contour is reshaped, and the breast is elevated, giving it a firm and lifted appearance.
What a breast lift does not do is add volume. Women who have lost significant volume alongside sagging may wish to consider combining a lift with augmentation or fat grafting, while those who prefer volume reduction alongside a lift may be better assessed for breast reduction surgery. These are distinct procedures with different goals, and the approach that suits you depends on what you are looking to change, and is assessed at consultation.
Why Breasts Sag (and Degrees of Ptosis)?
Several factors may contribute to breast ptosis over time. This includes:
- Ageing: As skin loses elasticity and the ligaments supporting the breast tissue stretch, the breast gradually descends on the chest wall.
- Pregnancy and Breastfeeding: The breast enlarges considerably during pregnancy and then involutes after breastfeeding ends, often leaving the skin envelope larger than the underlying tissue.
- Weight Fluctuations: Gaining and losing weight may stretch the skin and alter the fat-to-glandular tissue ratio in the breast, which can result in sagging even after weight stabilises.
- Gravity: Sustained downward force over time stretches the supporting ligaments progressively, particularly in larger or heavier breasts.
- Genetics: Skin elasticity, ligament strength, and breast composition are partly inherited, which is why some women develop significant ptosis earlier than others.
Understanding Ptosis Grading
To recommend the right technique, a surgeon first assesses the degree of sagging by measuring the position of the nipple relative to the inframammary fold, the crease where the underside of the breast meets the chest wall.
- Pseudoptosis: The nipple sits at or above the inframammary fold, but the lower pole of the breast has descended below it, creating a deflated appearance without true nipple descent.
- Grade 1 (Mild Ptosis): The nipple sits at the level of the inframammary fold, pointing forward rather than downward.
- Grade 2 (Moderate Ptosis): The nipple has descended below the inframammary fold but still sits above the lowest point of the breast.
- Grade 3 (Severe Ptosis): The nipple sits below the inframammary fold and at or near the lowest point of the breast, often pointing downward.
The degree of ptosis directly influences which surgical technique is recommended. Mild sagging may require only a small periareolar incision, while severe ptosis typically requires an anchor-pattern technique to remove the additional skin and reposition the breast fully.
Breast Lift Techniques
The incision pattern used in a mastopexy is determined by the degree of ptosis and the amount of skin to be removed. Four main techniques are used, ranging from minimal to more extensive incisions.
- Periareolar (Donut) Lift: A single circular incision around the areola border removes a ring of skin to reposition the nipple slightly, producing a scar confined to the areolar border and suited to very mild ptosis or pseudoptosis.
- Crescent Lift: A small crescent-shaped incision along the upper half of the areola allows for minor nipple repositioning and is appropriate only in specific, limited presentations where the lift required is very small.
- Lollipop (Vertical) Lift: Two incisions, one around the areola and one running vertically to the inframammary fold, allow for more significant reshaping and are suited to moderate ptosis where a horizontal scar along the breast crease is not needed.
- Anchor Lift: Three incisions, around the areola, vertically down the lower breast, and horizontally along the inframammary fold, produce the most complete correction and are appropriate for significant or severe ptosis with substantial skin excess.
Combining a Breast Lift With Augmentation or Fat Grafting
While a mastopexy (breast lift) effectively corrects sagging by removing excess skin and repositioning the breast, it does not restore lost fullness. For individuals experiencing both volume loss and sagging, both concerns can often be addressed in a single combined procedure, usually by pairing the lift with breast implants or fat grafting.
- Augmentation-Mastopexy (Lift With Implants): A breast lift can be performed with implant placement to restore upper pole fullness while correcting position, though the combination is technically more complex than either procedure alone.
- Lift With Fat Grafting: Where modest volume restoration is appropriate and you prefer not to use implants, autologous fat grafting can be performed alongside the mastopexy using fat harvested from elsewhere on the body, with the understanding that achievable volume is more limited than with implants.
- Lift Only: Women who are content with their breast size but not their breast position are often well suited to mastopexy without augmentation.
For women considering implants alongside a lift, further information is available on the Argent breast augmentation surgery page.
Do You Need a Breast Lift?
Women who consider mastopexy may notice one or more of the following:
- Nipple Position: The nipple sits at or below the inframammary fold when unsupported, or points downward rather than forward.
- Deflated or Elongated Appearance: The upper pole of the breast has lost fullness, and the breast has a flattened or stretched shape rather than a rounded one.
- Excess Skin: There is wrinkling or loose skin around the breast that was not present before pregnancy, weight loss, or significant ageing changes.
- Asymmetry of Descent: One breast has descended more than the other, creating a visible difference in nipple height or breast position.
Suitable candidates often include women whose breasts have descended following pregnancy and breastfeeding, those who have lost weight and are left with a larger skin envelope than their breast tissue now fills, and those whose breasts have sagged gradually with age. Candidates should be in good general health, have a stable weight, and have completed their family, as subsequent pregnancy may alter the result.
Preparing for a Breast Lift
The specific requirements for each patient are confirmed during consultation. The following steps are typically relevant.
- Breast Screening: A mammogram or breast ultrasound may be recommended before surgery, particularly for women over 40 or those with a family history of breast conditions.
- Medication and Supplement Disclosure: Aspirin, anti-inflammatory drugs, and certain herbal supplements affect bleeding and healing and must be reviewed before surgery.
- Smoking Cessation: Smoking impairs wound healing and increases complication risk; cessation is required before surgery is appropriate.
- Weight Stability: Surgery is most appropriate when weight has been stable for a sustained period, as significant fluctuations after the procedure may affect the result.
- Completing Family Planning: Women planning further pregnancies are generally advised to defer mastopexy, as subsequent pregnancy may alter the surgical result.
Breast Lift Surgery at Argent
At Argent Plastic Surgery, breast lift surgery is performed by Dr Lee Hanjing, a Consultant Plastic Surgeon, a Fellow of the Academy of Medicine Singapore (FAMS, Plastic Surgery).
Dr Lee brings a refined approach to breast contouring. Her clinical background spans cosmetic, reconstructive, and paediatric plastic surgery, and it is this depth that informs her approach to breast shape and anatomy across different patient presentations.
Your journey begins with a comprehensive, low-pressure initial assessment. This first consultation is dedicated entirely to evaluating whether surgery is the right path for your unique anatomy and goals, and places you under no obligation to proceed.
How to Choose a Plastic Surgeon for a Breast Lift
Choosing a surgeon for mastopexy is as much about the quality of the assessment as the procedure itself. The following are reasonable criteria to apply.
- Specialist Accreditation: The baseline for any qualified practitioner is formal Ministry of Health (MOH) accreditation and Singapore Medical Council (SMC) registration as a specialist in plastic surgery. Beyond these regulatory standards, active membership in professional bodies like the Singapore Association of Plastic Surgeons (SAPS) reflects peer recognition and an ongoing commitment to surgical excellence within the field. Read more about Dr Lee.
- Scope of Breast Surgery Practice: A surgeon who performs both cosmetic and reconstructive breast surgery has a broader frame of reference for breast anatomy and what constitutes an appropriate outcome across different presentations.
- Quality of Consultation: A thorough assessment, a clear explanation of the recommended technique and its rationale, an honest discussion of limitations, and time for questions are the relevant standards; feeling pressured after a consultation is a reasonable basis for seeking a second opinion.
- Clear Explanation of Techniques and Risks: The technique recommended should be explained in relation to your specific degree of ptosis, and the risks relevant to your situation should be discussed before any decision is made.