Mastopexy to restore youthful breast shape, elevation, and nipple position — without changing your size.
Overview
There are changes that no amount of exercise can undo. When the breast loses its position on the chest wall — the nipple descending below the breast fold, the skin stretching, the youthful roundness giving way to elongation — the problem is structural, not muscular. A breast lift, or mastopexy, addresses these changes surgically: reshaping the breast, elevating the tissue, repositioning the nipple, and removing the excess skin that is preventing the breast from maintaining its form.
It is important to understand what a lift does and does not do. Mastopexy is a procedure about shape and position, not size. It does not add volume. Most women who have a breast lift find that their breasts look very similar in size before and after — perhaps slightly fuller in the upper pole due to the more compact, elevated position of the tissue — but the dramatic transformation is in how the breast sits on the chest wall. A breast that previously drooped significantly can be restored to a position that looks and feels decades younger.
If volume restoration is also a goal — if the breasts have become not only ptotic but also deflated, often as a result of pregnancy and breastfeeding — Dr. Newman may recommend an augmentation mastopexy: a combined procedure that lifts and reshapes while simultaneously restoring fullness through implants or fat transfer. This combination is among the most commonly requested procedures in his practice, and it allows for both concerns to be addressed in a single surgery with a single recovery period.
Breast ptosis — the medical term for sagging — is classified by the position of the nipple relative to the breast fold (inframammary crease). This classification directly guides the surgical approach. Grade I ptosis (mild) places the nipple at or near the fold. Grade II (moderate) places the nipple below the fold but still pointing forward. Grade III (severe) places the nipple well below the fold, often pointing downward. Pseudoptosis describes a situation where the nipple position is acceptable but the lower breast tissue has descended, creating an empty, deflated lower pole — a pattern commonly seen after significant volume loss.
The degree of ptosis, along with the size and overall anatomy of the breast, determines which incision pattern will produce the best result for a given patient. This is not a one-size-fits-all decision, and Dr. Newman takes it seriously.
Breast ptosis results from the gradual breakdown of several structural systems that support the breast. The skin envelope is the most visible factor — as the skin stretches and loses elasticity, it can no longer hold the breast tissue in its original position. The supportive ligaments within the breast (Cooper's ligaments) also stretch over time. Pregnancy and breastfeeding cause the most rapid and dramatic changes: the breast tissue enlarges significantly under hormonal influence, stretches the skin, and then involutes after weaning — leaving a deflated breast in an already-stretched envelope. Significant weight fluctuations produce a similar dynamic. Gravity acts continuously over years, and genetics determine how quickly and how much any individual's breast will respond to these forces.
Ptosis Classification
The appropriate surgical technique is determined in part by the degree of breast ptosis. Dr. Newman assesses this carefully during consultation and uses it to guide incision planning.
The nipple sits at or within one centimeter below the inframammary fold. The lower breast contour may show minor fullness below the fold. A periareolar (donut) lift is often sufficient for Grade I ptosis, producing minimal scarring with effective improvement in shape and nipple position.
The nipple sits 1–3 centimeters below the inframammary fold but continues to face forward. This is the most common degree seen in Dr. Newman's practice. A vertical (lollipop) mastopexy is typically the most appropriate technique, providing reliable correction with more limited scarring than a full anchor pattern.
The nipple sits more than 3 centimeters below the fold, often pointing downward. Significant skin excess and tissue descent are present throughout the breast. The anchor (Wise pattern) mastopexy is required to achieve adequate elevation and remove the extent of excess skin present. This technique produces the most visible scarring but also the most substantial improvement.
Surgical Approach
The incision pattern is chosen based on the degree of ptosis, breast size, and the amount of skin that needs to be removed. Dr. Newman selects the technique that provides the best result with the least scarring for each patient's specific anatomy.
A circular incision is made around the border of the areola, and a ring of skin is removed. The areola is reduced in size if desired, and the remaining skin is gathered and sutured at the areola border. This technique leaves a single scar at the natural pigment boundary — an area known for excellent healing and minimal scar visibility. Best suited to patients with mild ptosis and good skin quality.
A periareolar incision is combined with a vertical incision running from the lower areola to the inframammary fold. This pattern allows more significant nipple elevation and breast reshaping than the periareolar technique alone. The vertical scar sits in the center-lower breast and is typically well concealed within the breast's natural contour. Dr. Newman's preferred technique for the majority of mastopexy patients.
The most comprehensive technique: periareolar, vertical, and horizontal incisions combine into an anchor shape. The horizontal component runs along the inframammary fold and is concealed within it. This pattern is reserved for patients with significant ptosis and excess skin who cannot be adequately corrected with the lollipop technique. It provides the most substantial elevation and reshaping but produces the most extensive scarring.
Combined Procedure
Many women who seek consultation for a breast lift discover that what they are most bothered by is not simply the position of the breast, but the combination of lost volume and skin laxity that pregnancy, breastfeeding, or weight changes have produced together. A lift alone will reshape and elevate — but if the breast has also become significantly deflated, the result may still look smaller than desired after surgery.
Augmentation mastopexy addresses both concerns simultaneously: a mastopexy to restore shape and position, combined with either silicone or saline implants (or Dr. Newman's Forever Breast® fat transfer) to restore the volume that was lost. Performing both procedures together means a single anesthesia event and a single recovery period rather than two separate surgeries.
This combination is technically demanding — the two procedures can work in opposition to each other if not planned carefully — and requires the precise judgment that comes from specialized training and experience. Dr. Newman's fellowship background in breast surgery makes him particularly well-suited to this procedure.
"The question I hear most is: Do I need a lift, implants, or both? There is no universal answer — it depends entirely on your anatomy. That is what consultation is for."
— Dr. Michael K. Newman, MD, FACS
Schedule a ConsultationThe Process
Dr. Newman's team guides every patient through each step of the process. Here is what your breast lift journey typically looks like.
Dr. Newman performs a thorough breast examination, assesses your degree of ptosis, and discusses your goals. He will recommend the appropriate incision technique and, if applicable, discuss whether an augmentation mastopexy would better serve your aesthetic vision. You will see photos of similar cases and have all your questions answered.
Surgery takes 2–3 hours under general anesthesia at an accredited outpatient facility. Dr. Newman reshapes the breast tissue, excises the planned skin, elevates the nipple-areola complex, and closes in precise layers. You return home the same day wearing a soft surgical bra provided by the office.
Most patients return to desk work within 1–2 weeks. The surgical bra is worn continuously for the first several weeks, then transitioned to a supportive soft bra for 6 weeks total. Light activity is appropriate at 2–3 weeks; exercise resumes at 4–6 weeks. Scar care begins at 2–3 weeks and continues for several months.
You will see the transformation immediately — with some swelling and bruising normal in the first two weeks. The final result, with scars faded and swelling resolved, is visible at 3–6 months. Scars continue to mature for 12–18 months, typically fading to a pale, nearly imperceptible line.
Gallery
A selection of Dr. Newman's mastopexy results. All patients shown are real patients who have consented to share their photos.
*Each patient is unique. Results may vary. Photos are shown with patient consent.
Frequently Asked Questions
Take the First Step
Meet with Dr. Newman in his Beverly Hills office to discuss your goals, assess your degree of ptosis, and receive a clear recommendation on technique and approach. All consultations are private, thorough, and conducted at a pace that allows you to ask every question you have.