Due to factors such as pregnancy, weight fluctuation, and the effect of gravity as we age, the breasts can lose their youthful position and tone over time. The position of the nipple drops and the breast acquires a disproportionate amount of skin in relation to the underlying tissue. Mastopexy is a procedure performed to counteract these problems, offering a more youthful appearance to the breasts. The nipple is elevated and the amount of redundant skin is reduced, offering a better shape.
It should be noted, however, that this procedure does not typically offer a long-term increase in upper fullness unless an implant is used. Depending on the patient’s goals and concerns, an implant may or may not be used. Women with small breasts see the best results with this procedure. Due to the effects of gravity on heavier breasts, the results for women with larger breasts are not as long lasting.
As a plastic surgeon, I believe it is important to spend at least an hour discussing medical history and goals with potential patients, although consultation time may vary from surgeon to surgeon. Along with the medical history, an examination should also be done to assess the current shape, size, skin tone, and degree of ptosis (drooping). Incision options and implant usage should be discussed, as well as implant styles and placement options. Each individual has their own goals and unique anatomical considerations. A detailed consultation is essential to address these important issues.
No matter who performs your surgery, it should always be performed at a fully accredited surgical center, and anesthesia should be administered by board-certified anesthesiologists. Before surgery, the new position of the nipple should be planned, as well as the type of incision. While an incision is made around the nipple, the nipple remains attached to the underlying tissue, not “removed,” then it is repositioned to a higher location.
The scarring caused by the incisions will vary depending on the degree of nipple droop. The simplest incision option follows the top of the areola. Others, such as the “lollipop” technique, use a circular incision around the areola, and in more extensive lifts, an inframammary fold incision is added to form an “anchor” scar. If an implant is to be placed, the anchor incision is normally used.
After surgery, light tapes are placed over the incisions and a sports bra is applied. The patient usually goes home or to Serenity if she wishes. Serenity is a warm and comfortable facility designed for the postoperative care of the plastic surgery patient. At your pre-operative visit, you will be provided with a personalized brochure that further discusses the procedure, risks, and pre- and post-operative instructions.
During surgery, the surgeon will perform nerve blocks to help control initial discomfort. Patients can usually shower within 2 days. Use and movement of the arm are not restricted, although lifting associated with exertion is not recommended for at least 2 weeks. Postoperative pain is usually more intense during the first three days. It is usually well controlled with oral pain relievers.
By the end of the first week, much of the pain has subsided and many normal activities have resumed. In general, full physical activity is not recommended for about 3 to 4 weeks after the operation. Driving should not be done until oral narcotics are no longer required to control pain. It is recommended to wear a support bra at all times, except when showering during the first post-operative month.
What are some of the particular concerns regarding breast lift surgery?
Although most patients are very satisfied with the results, there are certain important considerations that must be taken into account. Mastopexy surgery, even in its simplest form, involves permanent visible scarring. While they do fade over time, they do not “disappear.” In addition, this surgery carries a risk of loss of sensation in the nipples and other areas of the breast skin.
Although most patients maintain most of their sensation, the possible loss of some sensation must also be considered. After mastopexy surgery, a recurring fall will definitely occur. In fact, the process starts over immediately when the “new” breasts are exposed to gravity. The heavier they are, the faster some recurring deformity occurs.
More mastopexy procedures may be desired in the future. In this procedure, although the position of the nipple is raised and the amount of excess skin hanging below the crease is reduced, there is usually no long-term increase in upper volume, as desired by almost all patients. This is usually only reliably achieved by the addition of implants, which may or may not be an appropriate and acceptable addition to the mastopexy procedure.
make the decision
Each surgical procedure has inherent benefits, risks, and limitations. Before choosing to undergo breast lift surgery, patients should use their preoperative visits to ask any questions they may have and take the time they need to determine if having mastopexy surgery is truly the right decision.