A breast lift consultation in Perth assesses the degree of breast drooping (ptosis), nipple-areola complex position, skin quality, breast volume, and overall anatomy to determine whether surgery is appropriate and, if so, which surgical approach suits the individual. Dr Mark Hanikeri FRACS (PLAS), a plastic surgeon at the Western Australian Plastic Surgery Centre, uses a standardised ptosis classification system during consultation to guide these decisions. Understanding what that assessment involves helps patients approach the process with accurate expectations.
What Is a Breast Lift (Mastopexy)?
A breast lift, known clinically as mastopexy, is a surgical procedure that repositions breast tissue, tightens the surrounding skin, and raises the nipple-areola complex to a higher position on the chest wall. It does not add volume to the breast. The procedure is performed under general anaesthetic and is used in patients with breast ptosis, a condition in which breast tissue has descended relative to the inframammary fold (the crease beneath the breast).
How Ptosis Is Classified
Ptosis exists on a spectrum. Its severity is assessed using a standardised classification system that categorises drooping as mild, moderate, or severe, based on the position of the nipple relative to the inframammary fold.
In mild ptosis, the nipple sits at or just below the inframammary fold. In moderate ptosis, the nipple is positioned further below the fold but still points forward. In severe ptosis, the nipple points downward and the breast tissue has descended significantly. A separate category, pseudoptosis, describes cases where breast tissue descends but the nipple remains above the fold. This distinction matters for surgical planning.
Grading is not based on appearance alone. Dr Hanikeri assesses skin thickness, skin laxity, and the distribution of breast volume alongside the nipple position. These factors, taken together, determine which incision pattern is appropriate and whether additional procedures need to be considered.
What Is Assessed During the Consultation
The breast lift consultation at the Western Australian Plastic Surgery Centre covers several specific elements of anatomy. Each informs a different aspect of the surgical plan.
Skin quality and elasticity: Skin that has undergone significant stretching through weight fluctuation, pregnancy, or breastfeeding may have reduced elasticity. This affects how the skin responds to repositioning and influences the durability of the result over time. Patients with lower skin elasticity are counselled about this during the assessment.
Nipple-areola complex (NAC) position: The position of the nipple and areola is central to mastopexy planning. Dr Hanikeri assesses where the NAC sits in relation to the inframammary fold and the overall breast mound. This measurement directly informs how much tissue needs to be repositioned and which incision pattern is used.
Breast volume: Mastopexy alone does not add volume. If a patient presents with both ptosis and significant volume loss, a combined mastopexy and augmentation may be discussed. This is an individual clinical decision based on anatomy. Both procedures carry separate surgical considerations and risks, and the discussion takes place at consultation based on the specific findings.
Breast symmetry: A degree of natural asymmetry is present in most patients. Where asymmetry is clinically notable, it is documented and taken into account in the surgical plan. Patients are informed that complete symmetry cannot be guaranteed as a surgical outcome.
General health and medical history: As with any procedure under general anaesthetic, a patient’s overall health, medications, and medical history are reviewed. Smoking status, body mass index, and history of breast disease are among the factors relevant to surgical risk and suitability.
The initial consultation fee is $300. Follow-up consultations are $150.
Incision Patterns Used in Mastopexy
The incision pattern selected depends on the degree of ptosis and the amount of tissue repositioning required. There are three main options.
A periareolar incision involves a circular incision around the outer edge of the areola, often called a donut pattern. This approach is generally suited to mild ptosis where limited elevation is required.
A vertical incision, often called a lollipop lift, adds a line from the base of the areola to the inframammary fold. This pattern is appropriate for moderate ptosis and allows more extensive repositioning than the periareolar approach.
An inverted T incision, also called an anchor or Wise pattern, adds a horizontal incision along the inframammary fold. This pattern is used where a greater amount of skin needs to be excised. It produces more scarring than the other two patterns but is suited to more significant degrees of ptosis where a lesser incision would not achieve adequate correction.
Scarring is present with all mastopexy incision patterns. The extent and visibility vary between individuals and are affected by genetics, skin type, and post-operative care. This is discussed with each patient prior to surgery.
Recovery
Mastopexy is performed under general anaesthetic. Recovery involves wearing a supportive bra for approximately six weeks following surgery to support the tissue during healing. Patients are advised to avoid strenuous upper body activity, including lifting and vigorous exercise, for four to six weeks.
Swelling and bruising are expected in the early weeks. The final appearance of the breast following mastopexy develops over several months as swelling resolves. Follow-up appointments are scheduled to monitor healing progress.
Surgical Risks
Mastopexy carries risks, as does any surgical procedure. These are discussed in detail at consultation and again at any pre-operative appointments. Known risks associated with breast lift surgery include:
- Scarring, which is permanent and varies in appearance between individuals
- Asymmetry between the two sides
- Changes in nipple or breast sensation, which may be temporary or permanent
- Infection requiring antibiotic treatment or further intervention
- Delayed wound healing or wound breakdown
- The need for revision surgery if the outcome is unsatisfactory or if complications arise
Risks are not identical for every patient. Individual factors including age, smoking history, skin quality, and the degree of ptosis all influence the overall risk profile. Dr Hanikeri reviews these in the context of each patient’s health and anatomy during the consultation.
Surgeon Qualifications in Australia
When researching breast lift surgery in Perth, patients will encounter practitioners holding different qualifications. Understanding these distinctions is relevant to the process of selecting a surgeon.
Dr Mark Hanikeri FRACS (PLAS) holds the Fellowship of the Royal Australasian College of Surgeons in Plastic and Reconstructive Surgery. This is the specialist surgical qualification in this field in Australia. Achieving this fellowship involves completing medical school, a general surgical training program, and a further accredited plastic surgery training program, a process that typically takes more than twelve years. FRACS specialists are recognised by AHPRA as specialist surgeons in their field.
The title ‘cosmetic surgeon’ is now a protected title under Australian law, meaning it is legally restricted to medical practitioners with specific accredited specialty training. To ensure the highest level of specialty qualification, patients should verify that their specialist holds a FRACS designation in plastic and reconstructive surgery. Dr Hanikeri’s AHPRA registration number is MED0001535106.
Frequently Asked Questions
What is assessed at a breast lift consultation?
A breast lift consultation assesses skin elasticity, ptosis grade, nipple-areola complex position, breast volume, symmetry, and general health. Dr Hanikeri uses a standardised ptosis classification system to grade ptosis as mild, moderate, or severe. This grading determines which surgical approach is appropriate. Patients are also assessed for overall surgical suitability, including medical history and any factors that may affect anaesthetic risk or healing.
What is the difference between a cosmetic surgeon and a plastic surgeon in Australia?
A plastic surgeon in Australia holds FRACS, the Fellowship of the Royal Australasian College of Surgeons in Plastic and Reconstructive Surgery, which requires more than twelve years of accredited surgical training. The title ‘cosmetic surgeon’ differs from the specialist qualification FRACS. Patients are encouraged to verify a practitioner’s qualifications and registration through the AHPRA register.
What does FRACS mean?
FRACS stands for Fellow of the Royal Australasian College of Surgeons (Plastic and Reconstructive Surgery). It is the specialist surgical qualification for plastic surgeons in Australia and New Zealand, indicating completion of an accredited plastic and reconstructive surgery training program recognised by AHPRA. Dr Mark Hanikeri FRACS (PLAS) holds this qualification and is registered with AHPRA under MED0001535106.
Do I need a breast lift or breast augmentation?
A breast lift (mastopexy) addresses ptosis by repositioning existing breast tissue and raising the nipple-areola complex. It does not add volume. Breast augmentation adds volume using implants but does not significantly correct drooping. Some patients present with both volume loss and ptosis, and in those cases a combined procedure may be discussed. The appropriate approach is determined by individual anatomy at consultation and cannot be advised without a clinical assessment.
Further Reading
- Breast Lift Surgery Perth: https://markhanikeri.com/breast-lift/
| Written by Dr Mark Hanikeri – Specialist Plastic Surgeon, Perth WA. Dr Hanikeri holds Fellowship of the Royal Australasian College of Surgeons (FRACS) in Plastic and Reconstructive Surgery and has practised in Perth for over two decades. Consultations are conducted at accredited facilities in Subiaco and Murdoch. |
