Awake breast surgery
Awake Breast Lift (Mastopexy) in Ottawa
A breast lift (mastopexy) raises and reshapes the breast by removing excess skin and tightening tissue. For selected patients it can be performed awake, with tumescent local anesthesia and light sedation.
Breast Lift (Mastopexy) at a glance
| Typical operating time | About 2 to 3 hours |
|---|---|
| Awake suitability | Often suitable in selected patients |
| Typical return to desk work | Desk work often within 1 to 2 weeks |
| Anesthesia | Local anesthesia with or without sedation. General anesthesia arranged if needed |
| Setting | Outpatient, with an anesthesiologist present throughout |
Times are typical ranges for planning, not promises. Your plan is individualized.
What is breast lift (mastopexy)?
The skin envelope is reduced, the breast tissue is reshaped and the nipple is moved to a higher position. The scar pattern, around the areola, vertical or anchor-shaped, depends on how much lift is needed.
Who may be a good candidate
- People whose breasts have lost shape, droop, or sit low with the nipple pointing downward
- Those who want better position and shape rather than a major size change
- Patients who are not planning pregnancy or major weight change soon
- Non-smokers in good general health, since smoking affects healing
Why awake breast lift (mastopexy) may work
Published series report mastopexy combined with augmentation under tumescent local anesthesia, and augmentation or augmentation-mastopexy under local anesthesia with intravenous sedation. A lift without an implant is generally shorter and does not involve a muscle pocket, which may make it well suited to an awake approach in the right patient. Local anesthesia also provides numbness that lasts into the first hours of recovery.
When awake may not be the right choice
Larger lifts, longer operations, or combined procedures may be better suited to deeper sedation or general anesthesia. We will tell you honestly if that is the safer plan for you.
Your awake breast lift (mastopexy) journey
1. Before surgery (pre-op)
Your breast shape, skin quality and nipple position are measured and your scar pattern is discussed so you know what to expect.
- A consultation to review your goals, health history, medications and previous surgeries, and a physical examination
- An anesthesia assessment to decide whether an awake plan is appropriate and safe for you
- Photographs, with your consent, and a written plan, quote and consent form
- Medication guidance, including when to stop blood thinners, certain supplements, and smoking or vaping
- Fasting instructions from the anesthesia team. Follow them exactly
- A ride home and an adult to stay with you after surgery
2. Day of surgery (intra-op)
You are marked while standing. Local anesthetic is infiltrated, sedation is added only as needed, and the skin and tissue are reshaped. You may be sat up briefly to check symmetry.
- You arrive, change, and meet the surgeon and anesthesiologist, and your markings and plan are confirmed
- An IV and monitors are placed. The anesthesiologist stays with you from start to finish
- Local anesthetic is given. Expect brief stinging, then numbness, and light sedation if planned
- You can listen to music, talk with the team, and tell us at any time if you feel discomfort
- Afterward you rest in recovery, receive written instructions and go home with your driver
3. Recovery (post-op)
You are observed in recovery, given written instructions and pain-control guidance, and scheduled for follow-up. Call us or seek urgent care for fever, spreading redness, severe or worsening pain, heavy bleeding, chest pain, shortness of breath, or leg pain or swelling.
| When | What is typical |
|---|---|
| Days 1 to 3 | Tightness and soreness. A supportive bra or dressing is worn. |
| Week 1 | Light activity and desk work for many patients. No heavy lifting. |
| Weeks 2 to 6 | Gradual return to exercise as directed. Scars are pink and firm. |
| 6 to 12 months | Scars mature and fade. Shape settles. |
Timelines are general and vary. Your surgeon gives you instructions specific to you.
Anesthesia options
Anesthesia options range from local anesthesia, with or without sedation, to general anesthesia. An anesthesiologist is present throughout your procedure and recommends an approach after reviewing your health, the extent of surgery and your preferences. If an awake approach is not suitable, general anesthesia is arranged. Plans can change during surgery if comfort or safety requires it, including deepening sedation or converting to general anesthesia.
Learn more: anesthesia options, levels of anesthesia, fear of intubation, and pain perception and music.
Alternatives
Implants or fat transfer for volume, a lift combined with an implant, or no surgery.
Risks
Scarring, asymmetry, changes in nipple sensation, wound-healing problems, loss of blood supply to the nipple in rare cases, recurrent drooping, bleeding, infection, and anesthesia-related risks.
Anesthetic risks include reactions to medications, breathing or airway events, the need to deepen sedation or convert to general anesthesia, and, rarely, transfer for further care. All surgery carries risk, and results are not guaranteed.
Frequently asked questions about awake breast lift (mastopexy)
Will a breast lift change my size?
A lift mainly changes position and shape. Size changes little unless an implant or reduction is added.
Can a breast lift be done awake?
In selected patients, yes. We assess your anatomy and the extent of lift needed at consultation.
What scars will I have?
Scars range from around the nipple to a vertical line, sometimes with a line under the breast. Your surgeon shows you the expected pattern.
Will the result last?
Aging, weight change, pregnancy and gravity continue to affect the breast.
Can I breastfeed afterward?
Often possible but not guaranteed. Discuss your plans before surgery.
Related procedures
- Awake Breast Augmentation with Lift (Augmentation-Mastopexy)
- Awake Breast Reduction
- Awake Nipple Reduction
Starting from $12,000 (CAD, before 13% HST), including surgeon, anesthesia and facility fees. Your written quote follows your consultation. See pricing and financing.
Explore your options at a consultation
References
- Ziani F, Tettamanzi M, Arrica G, et al. Safe and effective augmentation mastopexy with tumescent local anesthesia: a decade of experience. J Clin Med. 2024;13(20):6057. PMID 39458008
- Colque A, Eisemann ML. Breast augmentation and augmentation-mastopexy with local anesthesia and intravenous sedation. Aesthet Surg J. 2012;32(3):303-307. PMID 22290411
- Koumanis DJ, Colque A, Eisemann ML, Smith J. Breast surgery under local anesthesia: second-stage implant exchange, nipple flap reconstruction, and breast augmentation. Clin Plast Surg. 2013;40(4):583-591. PMID 24093654