Breast Lift (Mastopexy)
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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.) The breast lift is performed on women who have experienced sagging or drooping of the breasts. Several different techniques can be used to correct this condition depending on the degree of sagging. Surgery consists of removing excess skin from around the areola and from the bottom of the breast and rearranging the skin of the breast to tighten the skin envelope. In doing so, the position of the nipple and areola can be elevated to a more natural position.
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.
Dr. Vincent will examine your breasts and measure them while you're standing. He 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.
Depending on your age and family history, you may be required 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.
Breast lifts are usually performed under general anesthesia on an out-patient basis. The surgery is performed at a surgery center or a hospital.
Mastopexy usually takes two to three hours to perform. 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.
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.
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 Dr. Vincent.
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. The stitches will be removed after a week or two.
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.
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 our office.
Dr. Vincent 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.
Dr.Vincent 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.
A breast lift is not a simple operation, but it's normally safe. 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 pre-op and post-op instructions.
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.