Breast lift surgery, or mastopexy, raises and reshapes sagging breasts.
How is the surgery performed?
Techniques vary, but the most common procedure involves an anchor-shaped incision following the natural contour of the breast. The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola are moved to the higher position. The skin surrounding the areola is then brought down and together to reshape the breast. Stitches are usually located around the areola in a vertical line extending downward from the nipple area and along the lower crease of the breast.
Some patients, especially those with relatively small breasts and minimal sagging, may be candidates for modified procedures requiring less extensive incisions. One such procedure is the "doughnut (or concentric) mastopexy," in which circular incisions are made around the areola and a doughnut-shaped area of skin is removed.
If you're having an implant inserted along with your breast lift, it will be placed in a pocket directly under the breast tissue or deeper, under the muscle of the chest wall.
Will the surgery result in permanent scarring?
Mastopexy leaves noticeable, permanent scars, although they'll be covered by your bra or bathing suit. (Poor healing and wider scars are more common in smokers.)
How long does the procedure take?
Mastopexy usually takes one-and-a-half to three-and-a-half hours.
How long is the recovery time?
You may be up and around in a day or two, but don't plan on returning to work for a week or more, depending on how you feel. Avoid lifting anything above your head for three to four weeks.
Will I need anesthesia?
Breast lifts are usually performed under general anesthesia, which means you'll sleep through the operation. In selected patients, particularly when a smaller incision is being made, the surgeon may use local anesthesia combined with a sedative to make you drowsy. You'll be awake but relaxed, and will feel minimal discomfort.
Am I a good candidate for breast lift surgery?
The best candidates for mastopexy are healthy, emotionally stable women who are realistic about what the surgery can accomplish. The best results are usually achieved in women with small, sagging breasts. Breasts of any size can be lifted, but the results may not last as long in heavy breasts.
Many women seek mastopexy because pregnancy and nursing have left them with stretched skin and less volume in their breasts. However, if you're planning to have more children, it may be a good idea to postpone your breast lift. While there are no special risks that affect future pregnancies (for example, mastopexy usually doesn't interfere with breastfeeding), pregnancy is likely to stretch your breasts again and offset the results of the procedure.
In your initial consultation, your surgeon will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. Photographs will be taken for reference during surgery and after. The surgeon also will examine your breasts and measure them while you're sitting or standing. Variables will be discussed that may affect the procedure – such as your age, the size and shape of your breasts, and the condition of your skin – and whether an implant is advisable. You should also discuss where the nipple and areola will be positioned.
Be sure to tell your surgeon if you smoke and if you're taking any medications, vitamins or other drugs.
Your surgeon will give you instructions to prepare for surgery, including guidelines on eating and drinking, smoking and taking or avoiding certain vitamins and medications.
While making preparations, be sure to arrange for someone to drive you home after your surgery and to assist you for a few days, if needed.
Following surgery, you'll need to wear an elastic bandage or a surgical bra over gauze dressings. Your breasts will be bruised, swollen and uncomfortable for a couple days, but the pain shouldn't be severe. Any discomfort you do feel can be relieved with medications prescribed by your surgeon.
Within a few days, the bandages or surgical bra will be replaced by a soft support bra. You'll need to wear this bra over a layer of gauze around the clock for three to four weeks. The stitches will be removed after a week or two.
If your breast skin is very dry following surgery, you can apply a moisturizer several times a day. Be careful not to tug at your skin in the process, and keep the moisturizer away from the suture areas.
You can expect some loss of feeling in your nipples and breast skin caused by the swelling after surgery. This numbness usually fades as the swelling subsides over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally, it may be permanent.
Your surgeon will give you detailed instructions for resuming your normal activities. You may be instructed to avoid sex for a week or more, and to avoid strenuous sports for about a month. After that, you can resume these activities slowly. If you become pregnant, the operation should not affect your ability to breastfeed, since your milk ducts and nipples will be left intact.
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