A mastopexy (breast lift) should do more than elevate the nipple. It should restore breast shape, projection, and durability in a way that looks natural and holds up over time.
My approach to mastopexy is a structural, inside-out technique, shaped in large part by years of oncoplastic breast surgery — specifically, gland rearrangement after partial mastectomy, where tissue must be reshaped, supported, and secured in less-than-ideal conditions. That experience translates directly to cosmetic mastopexy, where longevity and internal support matter just as much as appearance.
Auto-Augmentation Mastopexy: Restoring Volume Without Implants
Many patients do not lack breast volume — it has simply settled into the lower pole. Auto-augmentation mastopexy uses your own breast tissue to recreate upper-pole fullness and projection without implants.
By reshaping and securing native tissue internally, I can often achieve the appearance of added volume while preserving a natural look and feel.
This is a key component of my mastopexy technique.
Fat Grafting: Optional, Targeted Refinement
Fat grafting is not routine, but it can be a useful adjunct in selected patients. When used, it allows subtle contour refinement of:
- The upper pole
- Cleavage
- Areas of asymmetry
Fat grafting enhances shape but does not replace structural support.
Internal Support (“Internal Bra”) Options
Skin alone is not a reliable long-term support structure. In selected patients, I incorporate internal support techniques to improve durability and reduce long-term stretch.
Temporary (Absorbable) Mesh
Provides early support during healing and then dissolves.
Best for: mild to moderate breast weight and good tissue quality.
Semi-Permanent Biosynthetic Mesh
Provides longer-lasting support (often 12–24 months) while integrating with native tissue.
Best for: heavier breasts or patients at higher risk of recurrent ptosis.
Permanent Acellular Dermal Matrix (ADM)
A biologic scaffold that becomes incorporated into the body and provides long-term reinforcement.
Best for: heavy breasts, poor tissue quality, or revision mastopexy.
Internal support is used selectively and strategically, never automatically.
A Tailored, Structural Approach
Each mastopexy is customized based on:
- Breast size and weight
- Tissue quality
- Degree of ptosis
- Primary versus revision surgery
- Individual aesthetic goals
The goal is consistent:
natural shape, upper-pole support, and results that hold up over time.
Visit our procedure overview of Mastopexy and breast lifts for more information, or you can book a consultation with Dr. Bovill at our Vancouver plastic surgery clinic.
Frequently Asked Questions
How is this mastopexy different from a standard breast lift?
Traditional mastopexy relies mainly on skin tightening. My approach focuses on internal tissue reshaping and support, which improves breast shape and durability.
What is auto-augmentation mastopexy?
Auto-augmentation mastopexy uses your own breast tissue to restore fullness, particularly in the upper pole, without implants.
Do I need implants with a mastopexy?
Not necessarily. Many patients achieve excellent shape and volume with auto-augmentation alone. Implants are discussed only if additional volume is desired.
What is an “internal bra”?
An internal bra refers to internal support techniques, such as mesh or biologic scaffolds, used in selected patients to reinforce the breast and reduce long-term stretching.
Is internal mesh used in every mastopexy?
No. Internal support is not routine and is recommended only when anatomy and goals suggest it will improve long-term outcomes.
Will the results look natural?
Yes. The goal is always a natural breast shape that feels and moves naturally, with support built internally rather than relying on skin tension alone.