Mastopexy in Singapore - Anatomical Restoration with Auto-Augmentation

Generally, there are three different types of mastopexy incisions: (i) peri-areolar (around the nipple, Benelli), (ii) vertical (lollipop, Le Jour), and (iii) anchor shaped (like an inverted T, Wise). This roughly corresponds to the degree of breast ptosis. The vertical and anchor-shaped incisions are actually the same as that used in breast reduction, so the key difference in mastopexy is, strictly speaking, no glandular breast tissue is removed and the remaining skin and subcutaneous tissue are re-shaped (like an external bra).

Therefore, in suitable patients with sufficient breast tissue, I perform a preservation-based breast lift using dermoglandular flaps, which maintain blood supply and the structural integrity of the breast. This allows breast tissue to be repositioned internally to provide volume and support - think of it as an implant made of your own tissue. The inferior dermoglandular flap technique has been validated as a safe and reliable method for reshaping breast volume without implants, with high patient-reported satisfaction in outcomes studies.

Because the existing tissue is reshaped rather than removed, results often feel more natural and can be longer-lasting than implant-based lifts. Modifications to the dermoglandular flap technique have also been shown to reduce the risk of bottoming-out deformity and areola distortion, common longer-term concerns with standard mastopexy. However, not all patients are ideal candidates; those with significant laxity or limited glandular volume may still benefit from combining a lift with breast implants.

For patients who have had previous implant removal, this approach can also serve as a reconstructive option, restoring shape by removing excess skin and subcutaneous tissue without introducing foreign material.

The key to a successful mastopexy result is nipple-areola complex (NAC) repositioning. In mastopexy, the nipple is lifted to a more natural level while maintaining blood supply and sensation. Crucially, when stitching the NAC, there is a tendency for it to stretch out over time, so careful and meticulous technique is required to avoid a circular shaped NAC becoming a tear-drop shaped NAC. This is done by re-draping the skin envelope to support the remaining breast mound (like an external bra) before placing the NAC at or just slightly below the apex, so as to achieve the 45:55 ideal breast proportion between the upper and lower pole (and thus nipple position), as pre-operative markings should serve only as a guide rather than a rigid template ie a cookie cutter approach.