Plastic Surgery

Breast lift (Mastopexy)

What is the Breast lift (Mastopexy)?

Breast lift (mastopexy) is the surgical procedure for tightening and/or reshaping sagging or asymmetrical breasts to give them a more youthful, attractive appearance. This procedure is usually chosen by women who experience breast changes due to aging, weight loss or gain, child feeding and other causes.

What is the procedure?

A breast lift is performed with general anesthesia and usually takes about one to three hours.

There are a few techniques that can be used during the breast lift surgery. The appropriate technique is determined by the surgeon and is based on:

- breast size and shape;

- the size and position of areolas;

- the degree of breast sagging;

- skin quality and elasticity as well as the amount of extra skin.

There are three common incision patterns: 1) around the areola, 2) around the areola and vertically down from the areola to the breast crease, and 3) around the areola, vertically down from the breast crease and horizontally along the breast crease.

After your doctor makes the incisions, the underlying breast tissue is lifted and reshaped to improve breast contour and firmness. The nipple and areola are repositioned to a natural, more youthful height. If necessary, enlarged areolas are reduced by excising skin at the perimeter. Excess breast skin is removed to compensate for a loss of elasticity.

After your breasts are reshaped and excess skin is removed, the remaining skin is tightened as the incisions are closed.

Some incision lines resulting from breast lifts are concealed in the natural breast contours; however, others are visible on the breast surface. Incision lines are permanent, but in most cases will fade and significantly improve over time.

Sutures are layered deep within the breast tissue to create and support the newly shaped breasts. Sutures, skin adhesives and/or surgical tape may be used to close the skin.

What kind of result can you expect?

Most breast lifts are completed with favorable results and without serious complications. However, breast lift results vary from woman to woman and also depend on whether any other type of surgery, such as breast augmentation or breast reduction, is performed in conjunction with the breast lift.

Breast lift surgery can create a perkier, shapelier appearance to the breasts. It can make breasts appear fuller but does not add volume to the breasts.

In the absence of any significant weight fluctuation or pregnancy, breast lift results should remain consistent for many years.

Recovery period and recommendations

After breast lift surgery, most patients report some degree of soreness or tenderness in the treated area. Any discomfort can be controlled with pain medication. Other common breast lift recovery side effects include swelling, bruising, numbness or changes in nipple sensitivity, itching around incision sites, and increased firmness or fullness in the breast tissue. These side effects should subside over the next few weeks, with some residual effects up to three months following the surgery. Although much of the swelling and bruising will disappear in the first few weeks, it may be six months to a year before your breasts settle into their new shape.

Before undergoing a breast lift procedure, it is important to realize that there will be some degree of scarring. These scars will fade gradually over the next few months to blend in with the surrounding skin.

Following the surgery, the breasts will be wrapped in surgical gauze covered by a gentle bra. While the gauze is on the breasts, patients must restrict their bathing to sponge baths to avoid getting the gauze wet.

After this initial period, a surgical bra must be worn for two to three months after a breast lift. Avoid wearing underwire bras during this breast lift recovery time. Wearing such garments as recommended by your surgeon will reduce swelling, discomfort, and the overall recovery time, as well as supporting the tissues as they heal in their new contours. Wearing supportive bras as much as possible after breast lift surgery is recommended to keep the degree of future drooping to a minimum and maintain post-surgery breast contours.

Most patients return to work about a week after a breast lift. It is important to ease back into daily activities gradually. Although you may not feel like it, most surgeons advice patients to walk and resume other light activities as soon as they are able to, which can reduce the recovery time. During this time, avoid physical activities that may strain the incisions, particularly actions such as bending over or lifting the arms above the head. Strenuous exercise must be avoided for a month to six weeks. Patients are also advised to avoid sleeping on their stomach for the first few weeks.

Possible side effects and complications

Loss of sensitivity is a common, although temporary, mastopexy risk. Nerve endings are severed during breast lift surgery, so you must be patient until they regenerate and sensations start to return. This can take several months.

All surgeries of the breast involve some scarring, which is permanent but will fade with time. People scar differently, and some women are more delicate than others. All scars appear red and lumpy at first. Also, some ethnic groups are prone to the formation of thicker scars. Your pattern of scarring in the past could be a good predictor of how you will scar following a Breast Lift. In most women, the scars will be less noticeable within one year. In rare cases, scars may require surgical revision or treatment. Poor healing and scarring are more common in smokers.

There is also a risk of hypertrophic scar tissue (red, raised lump on the skin), keloids (an overgrowth of tissue that grows beyond the boundaries of the original incision) or inner scar tissue. If you smoke or have a history of abnormal collagen formation or scarring, you may have irregular scarring.

The separation of the wound edges may be a risk of breast lift in some cases. If this occurs, keep the area very clean and contact your surgeon immediately. Revision surgeries are not always necessary but can be in some cases.

Although your surgeon will attempt to make your breasts as even in volume and height as possible, your breasts may be asymmetrical following surgery. It is very common to see some differences early on during the healing period. Afterwards, there may appear some slight differences between your breasts but it should be no more pronounced than that which would happen in breasts naturally. In some cases, additional surgery may be performed to improve symmetry.

Sometimes blood in the depth of the breast tissue can accumulate and form a blood collection, called a Hematoma. Seroma is a fluid that arises from the breakdown of accumulated blood or Hematoma. In cases with extensive dissection and manipulation of the breast tissues, most plastic surgeons place a drain in the depth of the breasts to remove accumulated blood and fluid and thus prevent formation of a seroma. After drains are removed, this fluid may re-accumulate in the breasts, especially following trauma or vigorous exercise. Additional treatment may be necessary to drain the accumulation of fluid from the breast.

Permanent hyperpigmentation (dark spots) from bruising are a risk of breast lift. Hyperpigmentation should subside in a matter of a few weeks but may stay for longer than expected.

There are more risks with this operation due to the fat and its surrounding tissues becoming necrotic (dead tissue). If the fat becomes necrotic from lack of blood supply, it tends to turn orange and drain from the incision; however, it can spread and worsen. If the tissue becomes necrotic, immediate treatment is necessary. You must have the tissue removed before it spreads, develops a major infection, or causes gangrene.

Necrosis of the breast tissue, breast envelope and or incision line is a very rare mastopexy complication, but there are increased risks in those with compromised wound healing abilities, a history of smoking, circulatory problems, and diabetes. The chances of necrosis are also increased after radioactive/chemotherapy treatment.

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