A few would disagree with the statement that women's breasts symbolize her most feminine physical characteristic.

Aesthetic plastic surgery of the breast is a compilation of procedures that range from simple augmentation to more complex lifting. Breast liftingma can be done alone or combined with an implant. In fact breast reduction is a form of breast lifting associated with removing breast tissue.

It is becoming increasingly obvious to the savvy plastic surgeon given the spectrum of breast shapes and conditions that simply using breast implants alone will not always produce aesthetically acceptable results.

In assessing breast geometry and design, the plastic surgeon must consider 3 crucial parameters:

1. Breast Volume & Shape,

2. Skin condition,

3. Nipple position

Although augmenting breasts can to some extent rectify the volumetric problem in an otherwise perfectly shaped breasts, the issues relating to nipple position and excessive skin envelope cannot be addressed.

Breast ptosis (pronounced "toe-sis") or droopiness is a condition that affects women of all ages. Although we tend to associate breast ptosis with old age, young girls after significant weight loss or post- breast-feeding are often faced with varying degrees of droopiness. For these women wearing supportive bra is essential in order to disguise their saggy breasts.

Breast lift surgery is therefore designed to return breast shape to a more youthful appearance in 3 ways:

1. Move the position of nipple-areola complex,

2. Remove excess breast skin,

3. Reshape the breast tissue

Although Mastopexy does not change the amount of breast tissue a woman has, it can change the shape dramatically. This in turn can affect the overall breast size and projection. However, there are cases where breast lifting needs to be combined with an implant to produce a desirable breast size. The combined breast lift-augmentation is considered one of the more difficult operations in plastic surgery. It can be performed in either one stage or more commonly in two stages.

Modern plastic surgery is about creating minimal scar in return for achieving the most desirable aesthetic outcome. The prospective patient should be aware of this delicate balance prior to embarking on this procedure.

The breast lift surgery is basically performed using 3 types of incisions:

1. Donut-shaped scar around the nipple-areola complex (Benelli-Goes),

2. Lolly-pop scar from the areola to the breast crease (LeJour-Hammond),

3. Traditional anchor-shaped scar (Wise pattern),

Further to the skin scarring pattern, breast tissue must be surgically contoured from an elongated shape into a more youthful conical structure. This maneuver is an integral part of breast remodeling process.

Given the right patient selection, Mastopexy can be quite a rewarding procedure. Patients must stop smoking for at least 4 to 6 weeks before and after the operation. Mastopexy is not a painful operation but discomfort can persist for a week or so. Time off work from this procedure is usually 10-14 days for recovery and healing to take place.

Dr Kourosh Tavakoli - Cosmetic Plastic Surgeon, MBBS, BSc (med), MS (unsw), FRACS (plast.) Dr Kourosh Tavakoli is a fully qualified Australian trained Plastic Surgeon specialising in Breast Implants.