Introduction: What is a Breast Lift?
Sagging breasts are a real concern for many women. Loss of skin elasticity, gravity and other factors such as pregnancy, and weight loss can cause the breasts to lose their natural shape and firmness.
A breast lift or mastopexy is a breast surgical procedure to lift and reshape the sagging breasts. Mastopexy involves repositioning the areola and nipple and may also alter the size of the nipple areola complex. Mastopexy does not significantly alter the size of your breasts, it just helps to bring the breast tissue that you do have into a more lifted and youthful position. Some women may have small breasts or may have lost a significant amount of breast volume after pregnancy. In such cases, placement of breast implants in addition to breast lift may be required to increase the size and firmness of the breasts. The implants are placed most often underneath the breast tissue or under the muscle of the chest wall.
Who is an Ideal Candidate for a Breast Lift?
- You are not currently pregnant or breastfeeding
- Your breasts are fully developed
- You are bothered by feeling that your breasts are too saggy
- Your breasts have a flatter, elongated or pendulous shape
- Your nipples hang below the breast crease or your nipples point downward
- Your breasts have failed to develop normally or are asymmetrical
- Healthy patients without significant medical comorbidities
- Patients with realistic expectations of what a breast augmentation can do for them
- Non-smokers
Preoperative Assessment
Before your procedure, a detailed medical history is obtained, and a thorough physical examination is performed. During your consultation, your doctor will advise you to stop smoking, if you smoke, to avoid post-surgical complications and delayed healing. You should eat a healthy diet and avoid any restrictive dieting during this time. You should inform your doctor of all medications that you are taking and about significant medical conditions, allergies and previous surgeries if any.
Photographs will also be taken during pre-operative consultation to submit for insurance, to be used in surgical planning and for before and after comparison. Your goals will be discussed, and realistic expectations will be set. After discussing surgical options, we will make an individualized surgical plan together that best suits your goals.
This is the best time to ask all your questions so that you can feel comfortable and confident going into surgery.
Procedure: Breast lift
On the day of surgery you will be seen in the pre-operative area by your surgeon. Anatomic landmarks will be drawn on your chest with a surgical markers. Guidelines for incisions will be made with you in the upright position for symmetry purposes.
Breast lifts are performed under general anesthesia. Depending on how much sagging skin you have your incision pattern may be different.
If you have significant sagging skin and your nipple has dropped significantly below your breast crease, you will likely have an anchor-shaped incision or inverted "T" incision that follows the natural contour of the breast. Again, depending on how much skin you have will influence how long the incision across the bottom of the breast is. Sometimes only the incison around the nipple and down the center of the breast is needed for a "lollipop" patter of skin excision. Another technique, especially for those with small breasts and minimal sagging, is the doughnut or concentric mastopexy, where circular incisions are made around the areola, and a doughnut-shaped area of skin or areola is removed.
Next, your surgeon will remove the excess skin and move your nipple and areola to a higher position. Then the skin around the areola is brought down and drawn together to reshape the breast. After completion of the procedure, stitches are placed around the areola and nipple area, in a vertical line beneath the nipple and along the lower crease of the breast depending on your incision pattern.
The incisions are closed with dissolvable sutures that will be under the skin and you will have either surgical glue or surgical tape over your incisions which take about 1-2 weeks to fall off. Your surgeon will place either a surgical bra or bandage over the incision, depending on what seems best in your case.
Risks and Complications of a Breast Lift
Breast reduction is a relatively safe procedure; however, as with any surgery, the following risks and complications are possible:
- Anesthetic risks
- Blood clots in the lungs or legs, cardiac and pulmonary complications
- Breast scarring
- Pain in the breasts
- Changes in sensation in the breasts or nipples
- Infection
- Bleeding (hematoma)
- Fat necrosis
- Asymmetric appearance of nipples or breasts or suboptimal aesthetic results
- Incomplete healing in the nipple area
- Delayed healing
- Accumulation of fluid in breast tissue (seroma)
- Possibility of revision surgery
Recovery after a Breast Lift Procedure
Most people can go home the same day of surgery if no complications are noted. In general, postoperative care instructions and recovery involve the following:
After breast lift surgery there will be some temporary pain, discomfort, bruising and swelling. Medications will be prescribed to relieve pain. You will wear a contoured elastic garment for extra support around the chest/breasts. Upon discharge, patients will be instructed about proper wound care and how to manage their drains at home if they have them. For women having a breast lift, you should avoid underwire bras for at least 6 weeks while healing. Stitches are usually dissolvable and internal. Specific post-operative care regimen to minimize scarring will be discussed with each patient. Strenuous physical activity and heavy lifting over five pounds is discouraged for six weeks post-operatively – details of this limitation will be discussed with you specific to the surgery that you will be having. You will likely be able to resume work in 1 to 2 weeks depending on what kind of job you have and how you are feeling. Full recovery may take a few months and you need to have follow-up appointments to ensure a positive surgical outcome.
Summary
Breast lift surgery can help to improve self-image and confidence. Your natural breast volume will now be sitting on your body in a more youthful, lifted position. Results will be evident immediately after surgery, but final results will take a few weeks to months for the breasts to settle and swelling to subside. In a breast lift all of your natural tissue is being used, that means that your tissue may succumb to gravity again in the future and over the years you may see your breasts stretch back out.
