This is a surgical procedure done to recontour and elevate the pendulous breast rather than to increase the volume. If simultaneous increase in size is desired, procedure is done in conjunction with breast augmentation by autologous fat transfer or usage of breast implants.

Advancing age, effects of pregnancy and lactation, weight reduction or gravity due to heavy breast, implant removal, leads to loss of elasticity and tone of skin leading to ptotic or pendulous breasts.

Ideal candidate is a healthy adult female with realistic expectations having droopy or ptotic breast wanting a lift to restore the youthful appearance.

• This is a 2 to 3 hours day care procedure depending on the size of the breasts and done under general anesthesia usually.
• Different techniques are used. The nipple areolar complex is elevated to an ideal natural position and the excess lax tissue is excised.
• If there is minimal droop only, a supra areolar crescent lift alone is done. Benelli Mastopexy (circum areolar lift) Lollipop (vertical scar mastopexy) or Anchor shaped (Inverted-T mastopexy) are the usual techniques depending on the breast droopiness, size and laxity of tissues.

Recovery Phase

• Most of the swelling and bruising decreases in 2 to 3 weeks.
• One can resume desk job in a week’s time.
• Avoid weight lifting, strenuous exercises and sexual activities for 6 weeks.
• A customized compression garment is to be worn for 6 weeks.
• The outcome of the lift improves over a period of six to twelve months.

Areola

Areola is the pigmented circular area surrounding the nipple on the breast. Enlarged disproportionate sized areola is embarrassment to both males and females. In females, due to the hormonal changes during pregnancy and lactation, areola can enlarge and darken resulting in a secondary aeriola. In a male enlarged areola may be seen along with gynecomastia (male breast enlargement) which gives a feminizing characteristic. It can be an isolated feature too in males.

Areolar reduction

This is a simple surgical cosmetic procedure to alter the shape or decrease the diameter of an enlarged areola.

An ideal areola diameter is 38 mm to 48 mm in females and in males around 28 mm.

• Ideal candidate is a healthy adult with realistic expectations having an enlarged or irregular shaped areola.
• It is done as an outpatient procedure under local anesthesia.
• Procedure can be combined with other procedures too. It is usually a part of mastopexy (breast lift) or breast reduction (reduction mammoplasty) procedure.
• Recovery is rapid. Most of the swelling and bruising resolves in 2 to 3 weeks.
• One can be back to work in 3 days.
• Avoid pressure on the chest, weight lifting and strenuous activities for 6 weeks.

Nipple Correction

Enlarged nipples (Macrothelia) can be psychologically distressing in both sexes. Nipples can be large, protuberant or droopy. Hormonal changes during pregnancy and lactation can enlarge or darken nipples in a female.

• An ideal nipple 6 to 10 mm in diameter with a projection of 6 to 10 mm. It is like a cylinder with a curved domal surface.
• Ideal candidate is a healthy adult with realistic expectation having a disproportionate enlarged nipple
• Nipple reduction is a surgical cosmetic procedure aiming to shorten the length, reduce its enlarged diameter or both. It can be combined with other breast related procedures. It may be a simple tip removal or a circumferential skin sleeve resection at the base.
• It is a short office procedure done under local anesthesia.
• Recovery is rapid.
• Most of the swelling and bruising resolves in 1 to 2 weeks.
• One can resume office work in 2 days.
• Avoid undue pressure on the chest or any other strenuous activities.

The procedure may have a risk of future lactational issues or loss of sensations. Majority of the patients are problem free.