Breast lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts - at least, for a time. (No surgery can permanently delay the effects of gravity.) Breast lift can also reduce the size of the areola, the darker skin surrounding the nipple.
If you’re considering a breast lift
Over the years, factors such as pregnancy and breast feeding take their toll on a woman’s breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag.
If your breasts are small or have lost volume – for example, after pregnancy – breast implants inserted in conjunction with mastopexy can increase both their firmness and their size.
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The best candidates for a breast lift
A breast lift can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.
The best candidates for a breast lift 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 breast feeding have left them with stretched skin and smaller 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 breast-feeding), pregnancy is likely to stretch your breasts again and offset the results of the procedure.
All surgery carries some uncertainty and risk
A breast lift is not a simple operation, but it’s normally safe when performed by a qualified plastic surgeon. Nevertheless, as with any surgery, there is always a possibility of complications or a reaction to the anaesthesia. Bleeding and infection following mastopexy are uncommon, but they can cause scars to widen. You can reduce your risks by closely following your surgeon’s advice both before and after surgery.
Mastopexy does leave noticeable, permanent scars, although they’ll be covered by your bra or bathing suit. (Poor healing and wider scars are more common in smokers.) The procedure can also leave some patients with unevenly positioned nipples, or a permanent loss of feeling in the nipples or breasts.
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Planning your surgery
In your initial consultation, I will examine your breasts and measure them while you’re sitting or standing. I will discuss the variables that may affect the procedure –such as your age, the size and shape of your breasts, and your skin condition – and whether an implant is advisable. We will also discuss where the nipple and areola will be positioned; they’ll be moved higher during the procedure, and should be approximately even with the crease beneath your breast.
I will describe the procedure in detail, explaining its risks and limitations and making sure you understand the scarring that will result. I will also explain the anaesthesia to be used, the type of facility where the surgery will be performed, and the costs involved.
If you have any questions, please ask, especially those regarding your expectations and concerns about the results.
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Preparing for your surgery
Depending on your age and family history, your surgeon may require you to have a mammogram (breast x-ray) before surgery. You’ll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking and medication.
While you’re making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.
Your breast lift will be performed in hospital as an in-patient and the operation will be performed under general anaesthesia. You can expect to stay in one or two days. Clinical photographs will be taken before your operation.
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Mastopexy usually takes one and a half to three and a half hours. Techniques vary, but generally involve an anchor-shaped incision following the natural contour of the breast, or an incision around the nipple and extending to the groove beneath.
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 downwards from the nipple area, and sometimes along the lower crease of the breast. Incisions outline the area of skin to be removed and the new position for the nipple. Skin formerly located above the nipple is brought down and together to reshape the breast. Sutures close the incisions, giving the breast its new contour.
After surgery, the breasts are higher and firmer, with sutures usually located around the areola, below it, and in the crease under the breast.
Some patients, especially those with relatively small breasts and minimal sagging, may be candidates for modified procedures requiring less extensive incisions. For example, the vertical mammaplasty leaves a scar around the nipple and from the nipple to the groove below.
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.
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After your surgery
After surgery, your breast will be supported with adhesive tape and dressings. Your breasts will be bruised, swollen, and uncomfortable, but the pain shouldn’t be severe. Any discomfort you do feel can be relieved with tablets prescribed by your surgeon.
After a few days, you can bathe and at about one week the tape will be replaced by a soft support bra. You’ll need to wear this bra around the clock for about three weeks. The stitches are usually absorbable and won’t need removing.
You can expect some loss of feeling in your nipples and breast skin. This numbness usually fades as the swelling subsides over the next six weeks or so, but in some patients, it may last a year or more, and occasionally it may be permanent.
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Getting back to normal
Healing is a gradual process. Although you will be up and about in a day or two, don’t plan on returning to work for a week or more, depending on how you feel.
Avoid lifting anything over your head for three to four weeks. If you have any unusual symptoms, don’t hesitate to call. You will be given 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 six weeks. After that, you can resume these activities slowly. If you become pregnant, the operation should not affect your ability to breast-feed, since your milk ducts and nipples will be left intact.
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Your new look
Every effort will be made to make your scars as inconspicuous as possible; but remember that mastopexy scars are extensive and permanent. They often remain lumpy and red for months, then gradually become less obvious and eventually they become pale. Fortunately, the scars can usually be placed so that you can wear even low-cut tops.
You should also keep in mind that a breast lift won’t keep you firm forever – the effects of gravity, pregnancy, ageing and weight fluctuations will eventually take their toll again. Women who have implants along with their breast lift may find the results last longer.
Your satisfaction with a breast lift is likely to be greater if you understand the procedure thoroughly and if your expectations are realistic.
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