A breast lift or mastopexy is designed to lift and reshape the breasts to a more aesthetic form and improve (raise) the breasts up on the chest. The object is to raise the breast tissue up the chest wall, reshape the breast to improve projection and form and reposition the nipple to the front or apex of the breast and finally to minimize any asymmetries between the two sides. In the strictest sense the breasts do not become appreciably smaller. There is some skin removed but the total volume of skin removed is quite small so the actual volume does not change significantly.
There is, however, often the visual illusion that the breast size has decreased. Normally before breast lift surgery the breasts hang down and appear long and often wide in the mirror. After surgery, when the breasts are lifted and given a more conical shape with improved projection, they appear significantly less long and less wide giving the appearance that the size has been reduced when in reality the total volume is essentially unchanged. There may also be a decrease in the cup size needed because with the decrease in sag and increase in “perkiness”, a larger cup may no longer be needed to cradle the breasts.
In some cases there is a desire on the patient’s part to have the breasts somewhat reduced at the time of a mastopexy. This is easily accomplished by removing some of the breast tissue to achieve the patient’s desire in terms of final breast size. This is, however, the patient’s choice.