Breast Lift

“Time, gravity and pregnancies can weigh heavy on your breasts.”
Breasts often lose their shape and firmness and begin to sag. While no surgery can permanently delay the effects of gravity, a breast lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts. Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. Breast implants inserted in conjunction with mastopexy can increase both their firmness and their size. If you’re considering a breast lift, Dr. Guy will give you a basic understanding of the procedure–when it can help, how it’s performed, and what results you can expect.

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.

Mastopexy Basics

Procedure:
Raise and reshape sagging breasts by removing excess skin and repositioning remaining tissue and nipples.

Length:
2 to 4 hours.

Anesthesia:
Local with sedation, or general.

In/Outpatient:
Usually outpatient.

Side Effects:
Temporary bruising, swelling, discomfort, numbness, dry breast skin. Permanent scars.

Risks:
Thick, wide scars; skin loss; infection. Unevenly positioned nipples. Permanent loss of feeling in nipples or breast.

Recovery:

Back to work:
1 week or more.

Strenuous activities:
1 month.

Fading of scars:
Several months to a year.

Duration of Results:
Variable; gravity, pregnancy, aging, and weight changes may cause new sagging.
Results may last longer or be enhanced when breast implants are inserted as part
of the procedure.

Consultation & Preparation

In your initial consultation, it’s important to discuss your expectations frankly with Dr. Guy, and to listen to her opinion. She will help you determine a desirable size and shape for your breasts based on your goals.

Dr. Guy will examine your breasts and measure them while you’re sitting or standing. 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.

Depending on your age and family history, Dr. Guy 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, not 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.

The Plastic 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.

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.

Recovery & Results

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. Guy.

Within a day or two, the bandages or surgical bra will be replaced by a soft support bra. The stitches are usually dissolvable. Some surface stitches may be removed in 4 to 7 days. Don’t plan on returning to work for a week or more.

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. Though scars are part of the mastopexy procedure, they can usually be placed so that you can wear even low-cut tops.

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. If you have any unusual symptoms, don’t hesitate to call Dr. Guy.

Dr. Guy 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.