Why Do Women Choose to Have a Breast Lift?

We explore this topic with Dr. Stefano Campa, specialist in plastic, aesthetic, and reconstructive surgery at Ars Medica Clinic in North Rome.

The main difference between mastopexy and breast augmentation (augmentation mammoplasty) lies in the indication for each procedure. Mastopexy is ideal for women with loose skin and deflated breasts.
In such cases, performing only a breast augmentation may result in a larger but sagging breast, which would later still require skin tightening. Therefore, mastopexy is often the more appropriate choice.

What Causes Breast Ptosis (Sagging)?

Several factors can impact the shape and firmness of the breasts, including:

• Significant weight loss

• Weight fluctuations over time ("accordion effect")

• Prolonged or multiple breastfeeding periods

• Natural tissue laxity, even in women who have never been pregnant or experienced major weight changes

These elements can cause the breast to droop prematurely or more noticeably, prompting many women to seek corrective surgery.

Is Mastopexy More Invasive Than Breast Augmentation?

Yes — mastopexy is generally more invasive than breast augmentation.
This is because, in addition to tissue reshaping, it often involves repositioning the nipple-areola complex, which may lead to more visible scarring and a higher risk of altered nipple sensitivity or changes in the ability to breastfeed after surgery. While not guaranteed, these risks are more common in mastopexy compared to standard augmentation procedures.

Can Mastopexy Be Combined with Breast Augmentation?

Absolutely. The combined procedure is known as a mastopexy with implants, or augmentation mastopexy.
In these cases, the surgeon removes excess skin, reshapes the breast, and enhances volume with a breast implant — ideal for women whose natural breast volume is insufficient for the desired result without prosthetics.

This combination is especially effective for patients with significantly deflated breasts, where lifting alone would not restore adequate shape or fullness.

Are Mastopexy Scars Very Noticeable?

The visibility of scars following a mastopexy, whether performed with or without implants, largely depends on the patient's preoperative clinical condition.
In some cases, only a periareolar scar (around the nipple) is required. For moderate breast ptosis (sagging), the scar typically extends vertically from the areola, and in more advanced cases, an additional horizontal scar in the inframammary fold is necessary, forming an inverted T pattern.

Unfortunately, the extent of scarring cannot always be minimized. However, we can significantly improve the quality and appearance of scars through meticulous suturing techniques and attentive postoperative care.
This includes the use of medical-grade silicone dressings and, over time (typically six months to a year after surgery), laser treatments to help reduce scar thickness and visibility.

Why Is the Preoperative Consultation So Important?

"The initial surgical consultation is a crucial step. Personally, I always conduct two," says Dr. Stefano Campa.

During the first consultation, we assess the patient's clinical condition, including tissue thickness and quality, as well as body proportions such as height and chest width. We also begin discussing implant selection, if relevant. This visit is essential not only for planning but also for understanding the patient's expectations — and determining whether they are realistic and achievable.

The second consultation is typically more detailed and procedure-focused.
This is when we finalize the choice of breast implants, if applicable, and go over the surgery in depth. It's also the opportunity for the patient to ask any remaining or new questions — especially those arising after researching online, where information is often inaccurate or misleading.
Clarifying misconceptions at this stage ensures that the patient is fully informed and comfortable moving forward with the procedure.