It is very unusual for a woman of any age to have perfectly matched, full, and uplifted breasts. Sagging, asymmetry, and nipple-areolar deformities are the primary reasons to surgically reshape the breasts. Most women request breast-lifting to be able to occasionally wear a strapless or braless dress and feel their breasts have a truly firm and youthful shape. The procedure has many variations, some with very minimal incision patterns. Dr. Ptak feels that it is appropriate for a mature woman of any age to be given the chance to reshape her breasts in order to enhance her appearance, self-confidence, and self-esteem. The best candidates for mastopexy are women with small, sagging breasts with a significantly descended nipple-areola due to past pregnancies, genetics, or aging and the sagging is too great to be treated with implant alone. If the nipple-areaolar complexes (pigmented areas around nipples) are enlarged a perioreolar mastopexy is possible. The procedure usually takes one and a half to three hours. The procedure is done on an outpatient basis under general sedation and local or general anesthesia. The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola are moved to the higher position. The skin surrounding the areola is then brought down and together to reshape the breast. Stitches are usually located around the areola, in a vertical line extending downwards from the nipple area and along the lower crease of the breast. Some patients, especially those with relatively small breasts and minimal sagging, may be candidates for modified procedures requiring less extensive incisions. One such procedure is the "doughnut (or concentric) mastopexy", in which circular incisions are made around the areola, and a doughnut-shaped area of skin is removed. If you are having an implant inserted along with your breast lift, it will be placed in a pocket directly under the breast tissue, or deeper, under the muscle of the chest wall. The patient goes home in a bra with only light dressings over the incision lines. The bra is worn as a "dressing" for 2-3 weeks. Sutures are usually buried and completely dissolvable; no suture removal is necessary. Initial discomfort is easily controlled with oral medication. Light activities may be started in 7-10 days. Additional procedures that may enhance the result are a small breast reduction or breast enlargement using implants with mastopexy.