As the years go by, almost every woman notices a gradual deterioration in the size, shape and feel of her breasts. Gravity, pregnancy, breast-feeding, weight gain and loss all take their toll. Breasts sag. Droop. Soften. Flatten out. Sometimes, they atrophy and shrink. Even if the volume stays the same, the firmness, elasticity and erect youthful position are often lost. The breasts may look and feel old. But they don't have to. A breast lift can help. It can reshape, rejuvenate, firm up, lift up and shape up sagging, shrinking, atrophied breasts. And even though a breast lift won't last forever - nothing can delay the effects of gravity forever - it can make a dramatic difference in your appearance. It can also reduce the size of an enlarged, stretched areola (the dark pink skin around the nipple).
The best candidates for this procedure are women with small to medium, sagging breasts. The procedure can be done on breasts of any size but the results tend not to last as long on heavy breasts. Many women want to have a breast lift because pregnancy and nursing have given them stretched skin and less volume in their breasts. But if you are planning to have more children, you should postpone your breast lift. Any pregnancy is sure to stretch your breasts again and will negate the results of the procedure.
Typically, breast lifts are performed under general anesthesia, so you will sleep through the operation. In some patients - particularly when a smaller incision is being made - the surgeon may need to use only local anesthesia combined with a sedative that will make you drowsy. You'll be awake during surgery but relaxed, and will feel minimal discomfort.
Usually the surgeon makes incisions around the areola and down the front of the breast mound. Excess skin is removed. The nipple, areola and underlying breast tissue are lifted up to a new, higher position, and the skin that used to be above the nipple is now brought down, around and together to reshape and lift the breast. In a few patients, the incision around the areola can be avoided. The procedure takes between one and three hours. After surgery, a gauze dressing is wrapped carefully around the breasts or they are placed in a surgical bra. Medication can control any pain or discomfort, which will subside in a day or two. Swelling and bruising generally subside in a few days.
You may feel a temporary loss of sensation in your nipples and breasts. This will improve with time. You may be up and around a day or two after surgery but don't plan on returning to work for a week. Within a week after surgery, the dressing is replaced with a soft bra, which you'll wear for several weeks. The sutures come out within a week. Although every effort is made to make scars as inconspicuous as possible, they are permanent. For several months they may remain highly visible, then fade to some degree. Since they are around and below the nipples, scars shouldn't be noticeable even in low-cut clothing or a bathing suit. They'll fade with time and are easily concealed by a normal brassiere.
Afterwards, your lifted breasts should look younger, healthier and rejuvenated.
Benefits
You don't like the way your breasts are shaped and maybe you never have. They sag. They droop. However, you aren't looking for larger breasts or implants. You like the size of your breasts, just not the way they're shaped. A breast lift can help you because this procedure reshapes the breasts and makes them firmer, without changing the size. So its benefits may be exactly what you're looking for.
A breast lift will:
Change the shape of the breasts without changing the size Will provide a better-looking contour for drooping breasts Help clothing to fit better and look better on you Make your breasts look as young as the rest of you Make your breasts appear firmer Not require implants Improve how you feel about your breasts and yourself Breast tissue changes as you age. Those changes cause the breasts to lose elasticity and fat. And that causes sagging. But aging isn't necessarily the reason; an extreme change in weight, pregnancy, breast-feeding or good old genetics can cause also cause sagging and drooping. How much time you spend not wearing a bra can do it too. Whatever the reason, the way your breasts look now, is most definitely not the way they used to look.
Are You A Good Candidate?
Your breasts aren't what they used to be. You'd like to make them firmer, maybe improve their shape. But you don't want to change their size. You're happy with the size. If this is how you're feeling, you may be a good candidate for a breast lift. 
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You're a good candidate for breast lift procedure if:
You like the size of your breasts, but not the shape. Your breasts are pendulous. Your breasts lack substance and firmness. Your nipples point down below the breast crease. Childbirth has left you with sagging breasts. Time and gravity have taken away your perky breasts. You've inherited your Mother's droopy breasts. Again, as with any procedure, if you're healthy physically, emotionally and mentally then you're a good candidate. Your Consultation
This is such an important step. The step that brings you that much closer to making the big decision: should you or shouldn't you? The two main functions of your consultation are to get information and to ask questions. Once you're given enough information about the procedure and what it can do for you, you'll be in a better position to make that decision.
As is key with all cosmetic surgeries, you should tell the doctor how you want your breasts to look. This is so basic, but sometimes it's not discussed enough. Once your goals and expectations are known, you'll be told if those expectations are realistic. If they are, and your goals can be achieved, the surgeon should explain to you the procedure that will be done.
There are a number of factors that help the doctor evaluate you for a breast lift procedure: Your age, the size and shape of the breast, and the quality of the breast skin are some of these factors.
Your breasts will be examined and measured. Photographs may be taken for your medical records and for reference both during and after the procedure.
The initial consultation is also the best time to discuss what, if any, risks are involved. You should also be told what kind of anesthesia will be used and where the procedure will be done. And of course, the costs of the procedure and if it's covered by insurance.
Please come to the consultation prepared to be completely open with the doctor. Be ready to talk about yours and your family's medical history. Do you have any allergies? What medicines are you taking? Have you ever had any medical treatments? Past surgeries? Have you ever had a breast biopsy? Do you smoke? Everything that has to do with you medically can affect the procedure as well as the recovery process.
Also, if you're planning on losing a great deal of weight, the doctor may tell you to do so before going ahead with the procedure.
Remember, a breast lift will give you firmer, reshaped breasts. It will give you a better contour in clothes. Your breasts will be more like they used to be. But you'll still be you. A breast lift may transform your figure in clothing, but it won't magically transform who you are. So make sure you review your expectations with your doctor.
Risks
During your consultation, the surgeon should go over risks, if any, associated with this procedure and all surgeries in general. The breast lift is not considered a simple procedure, although most women do not experience complications.
Some potential complications linked to all surgeries are bleeding, infection and an adverse reaction to anesthesia. Make sure you find out beforehand what anesthesia your doctor will be using.
Though not a risk, per se, you should be aware going in that this procedure does leave noticeable, though easily covered, scars. (95% heal with thin, flat scars; 5% have permanent, raised, red scars).
Other potential risks include: nipple height may be uneven (this can be adjusted at a future date); incisions may heal poorly; and permanent loss of sensation (rarely happens).
Keep in mind that following all of your doctor's instructions prior to the procedure will go a long way toward avoiding complications.
Preparing Before The Procedure
Depending on your age and family history, your doctor may tell you to have a baseline mammogram before the procedure and another some months later. These will be used to compare with ones taken in the future.
You'll be given detailed instructions on eating, drinking, and taking or avoiding certain vitamins and medications. You'll also be asked to stop taking aspirins and certain anti-inflammatory drugs because they can cause excessive bleeding.
If you're a smoker, you'll be asked to stop at least 2 weeks before the procedure; smoking inhibits healthy healing of scars.
The day of the procedure, make sure you've followed all the doctors' instructions. And please feel comfortable asking any last minute questions.
Where Your Procedure Will Be Performed
Although usually done as an outpatient, your breast lift procedure can be performed in the hospital (as an inpatient), in an ambulatory facility or in a surgical suite in your doctor's office.
You may chose, or your doctor may decide to do the procedure in the hospital as an inpatient. This would mean a one or two day stay.
Anesthesia
Most likely your procedure will be performed using a general anesthesia. So you'll be asleep. If only a small incision is necessary, a local may be given in combination with a sedative. You'll be awake, though drowsy. You may also have some discomfort during the procedure.
The Procedure
A breast lift procedure takes approximately 1 to 3 hours. There are various techniques for a breast lift, but the one most commonly done is the following:
An anchor shaped incision is made tracing the contour of the breast. This incision marks the area where breast skin is to be removed and also shows where the nipple will be positioned. The breast skin is removed. The nipple and areola are moved up to a higher position. Skin around the areola is brought down and joined together to reshape the breast. Stitches are (usually) around the areola in a vertical line moving downward from the nipple and along the (lower) crease of the breast.
(The nipple and areola stay attached throughout the procedure to the tissue underneath; so sensation is usually retained and breast-feeding possible in the future.)
The areola can be reduced in size too if the sagging breasts have stretched it. Please note that very large breasts can be lifted, but results may not last as long.
Modified Breast Lift Procedures:
Depending on the size, shape and degree of sagging, you may be able to have a less extensive procedure with a modified procedure.
One common procedure is called The Doughnut (concentric) Mastopexy. A circular incision is made around the areola and a doughnut shaped area of the skin is removed. This is especially good for the woman whose nipples have not descended a lot or if you've got small breasts and not much sagging.
A second modified procedure is like the doughnut, but it connects to a vertical incision down the lower half of breast to the chest wall. There are other modified techniques that your doctor can talk to you about if you're thought to be a good candidate.
Breast lifts can be done at any age after the breasts are fully developed. And although many women decide to have a lift before having children, it may be a good idea to wait until after because pregnancy will most likely stretch the breasts and offset results of the lift.
Please note that breast implants can be inserted during the lift procedure (if you want larger as well as lifted breasts). Also, large breasts can be lifted, although the results my not last as long.
After The Procedure
Following your procedure, a small drain tube may be put into the breasts to allow for excess drainage. Gauze may be put on the breasts and then covered with bandage or surgical bra. Because no muscle has been cut, you won't have significant pain. A few hours after procedure, you can go home.
The day after the procedure, your breasts will be swollen and bruised. You will be uncomfortable for a few days. Your doctor can give you medication for pain.
In a few more days, the bandages (or surgical bra) will be removed and replaced by a soft support bra. You will have to wear the support bra 24 hours a day for as many as 4 weeks, until the swelling goes down. Usually a layer of gauze remains underneath the bra.
Any drains will be taken out a few days after procedure. The dressing may be removed or changed at the same time.
Stitches are taken out within a week after the procedure, often in stages. (There is also a second layer of stitches under the skin; these will dissolve over time.)
If your breast skin is overly dry, use a moisturizer, but be careful to keep it away from the incisions. Don't tug at the skin.
Some loss of feeling in the breasts is normal due to swelling. This usually fades as the swelling decreases, although some women report it has lasted up to a year. In very rare instances, loss of feeling is permanent.
Depending on how you feel and how physical your job is, you probably won't be back at work for at least a week. Maybe more.
After several weeks, normal activity can start up again. This may include gentle exercising, such as stretching. Wear a bra that unhooks in the front to minimize arm movement while dressing and undressing. For at least a month after procedure, do NOT wear an underwire bra. Sleeping in a bra will also help stop future sagging.
Do not try to lift anything over your head for at least 3 - 4 weeks. If you do anything too strenuous, or if you sleep face down, you could open the incisions.
Usually in a month, you'll be able to return to strenuous activity and sports. And though your doctor may ask you to wait longer, it's usually best to wait at least a week or two before having sex. After that, please be careful and gentle with your breasts for several more weeks.
If you become pregnant, you'll most likely be able to breast feed because the milk ducts and nipples have been left intact.
The new you will be the old you…just with lifted, firmer breasts.
Again, it's important you realize going into the procedure that you will have scars and although they may fade, they will be permanent. Of course, your surgeon will make them as inconspicuous as possible but they may stay lumpy and red for quite a few months. Often they'll fad to thin white lines. (Some incision lines remain prominent).
Remember it took you a while to decide to have this procedure…give yourself enough time to get used to it. Physical change brings with it some powerful emotional adjustments. Give yourself time to adjust to these changes.
The Results
You know eventually you'll stop standing in front of the mirror staring at yourself, but for now you just can't. It's too exciting. You love the way your breasts look. As well you should. You almost hate covering them up. But modesty prevails. So enjoy yourself. As with other breast surgeries, unless you gain or lose a lot of weight or become pregnant, your new breasts should retain their new shape for anywhere from five to ten years. Maybe longer. But keep in mind that time and gravity will have their way eventually. If you've had implants along with the lift, the results will last longer.
The Costs
National average cost for breast lift is $3,700, which does not include the surgical facility, anesthesia, medical tests, prescriptions, garments and other procedure related costs. Keep in mind the facility and anesthesiologist fees you pay prior to procedure are estimates. You may be billed for additional expenses, depending on the actual length of your procedure and the supplies used.