If
you're considering a breast lift...
Over the years, factors such as pregnancy, nursing,
and the force of gravity 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. 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.)
Mastopexy can also reduce the size of the areola,
the darker skin surrounding the nipple. 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. If you're
considering a breast lift, this information will
give you a basic understanding of the procedure
— when it can help, how it's performed, and
what results you can expect. It can't answer all
of your questions, since a lot depends on your
individual circumstances. Please be sure to ask
your doctor if there is anything about the procedure
you don't understand.
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The
best candidates for breast lift plastic surgery
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 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 breast-feeding), pregnancy is likely to stretch
your breasts again and offset the results of the
procedure.
Over time, a woman's breasts begin to sag
and the areolas become larger.
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All
breast 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 anesthesia. Bleeding and
infection following a breast lift are uncommon,
but they can cause scars to widen. You can reduce
your risks by closely following your physician'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 you
with unevenly positioned nipples, or a permanent
loss of feeling in your nipples or breasts.
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Planning
your breast lift plastic surgery
In your initial consultation, it's important
to discuss your expectations frankly with your
surgeon, and to listen to his or her opinion.
Every patient — and every physician, as well
— has a different view of what is a desirable
size and shape for breasts.
The surgeon will examine your breasts and measure
them while you're sitting or standing. He or she
will discuss the variables 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; they'll be moved higher during
the procedure, and should be approximately even
with the crease beneath your breast.
Your surgeon should describe the procedure in
detail, explaining its risks and limitations and
making sure you understand the scarring that will
result. He or she should also explain the anesthesia
to be used, the type of facility where the surgery
will be performed, and the costs involved.
Don't hesitate to ask your doctor any questions
you may have, especially those regarding your
expectations and concerns about the results.
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Preparing
for your breast lift plastic 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
taking or avoiding certain vitamins and medications.
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.
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Where
your breast lift surgery will be performed
Your breast lift may be performed in a hospital,
an outpatient surgery center, or a surgeon's office-based
facility. It's usually done on an outpatient basis,
for cost containment and convenience. If you're
admitted to the hospital as an inpatient, you
can expect to stay one or two days.
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Types
of anesthesia for breast lift surgery
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.
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The
breast lift surgery
Mastopexy usually takes one and a half to three
and a half hours. 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 downwards
from the nipple area, and 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. 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.
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After
your breast lift surgery
After surgery, you'll wear an elastic bandage
or a surgical bra over gauze dressings. Your breasts
will be bruised, swollen, and uncomfortable for
a day or two, 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 around the clock for three
to four weeks, over a layer of gauze. 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.
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Getting
back to normal after breast lift surgery
Healing is a gradual process. Although you may
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. And avoid lifting anything over
your head for three to four weeks. If you have
any unusual symptoms, don't hesitate to call your
surgeon.
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 breast-feed, since your
milk ducts and nipples will be left intact.
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Your
new look after breast lift surgery
Your surgeon will make every effort to make your
scars as inconspicuous as possible. Still, it's
important to remember that mastopexy scars are
extensive and permanent. They often remain lumpy
and red for months, then gradually become less
obvious, sometimes eventually fading to thin white
lines. 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, aging, 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.
If your expectations are realistic, chances
are you'll be satisfied with your breast lift.
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© Copyright American Society of Plastic
Surgeons
If you would like to contact New York plastic
surgeon Darrick Antell, or if have any further
questions about breast lift surgery or any of
our plastic surgery procedures, please use our
contact form.
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