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 breast. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. Breastlift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts. Mastopexy can also reduce the size of the areola. 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.
The goal of breast reduction is primarily focused on relieving patients of the physical disability created by their large, ptotic breast. Results of this procedure were far from ideal, however, and sometimes the price women paid for reduced breast size was a flattend breast contour and objectionable long scars, particularly along the inframammary fold, below the areola, and in the lateral breast area.
Vertical mammaplasty is one of the latest advances in the quest to improve breast reduction results. Based on a central and lower breast reduction with the areola carried on a superior pedicle, this technique leaves a circumferential scar around the areola and a vertical scar from the areola to the submammary fold with no horizontal submammary extension.
If you’re considering a breast lift or breast reduction, this text will give you a basic understanding of these procedures – 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 our doctor if there is anything about the procedure you don’t understand.
The best candidates for breast lift and breast reduction
A breast lift or breast reduction 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 our surgeon.
The best candidates for mastopexy and breast reduction 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.
Uncertainty and risk
A breast lift and breast reduction are not a simple operations, but they are normally safe when performed by a qualified 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 or breast reduction are uncommon, but they can cause scars to widen. You can reduce your risks by closely following our physician’s advice both before and after surgery.
Mastopexy and breast reduction do 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.
Planning your surgery
In your initial consultation, it’s important to discuss your expectations frankly with our 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 breast 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.
Our 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 our doctor any questions you may have, especially those regarding your expectations and concerns about the results.
Preparing for your surgery
Depending on your age and family history, our surgeon may require you to have a mammogram 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.
Types of anesthesia
Breast lifts are usually performed under general anesthesia, which means you’ll sleep through the operation.
The surgery
Mastopexy usually takes two to three hours, breast reduction takes three to four hours. Techniques vary, but the most common procedure involves vertical 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. With breast reduction the lower half of the breast is excised and the lateral pillars are sutured together below the new site of the areola. 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 and in a vertical line extending downwards from the nipple area to the lower crease of the breast.
Some patients, especially those with relatively small breast and minimal sagging, may be candidates for modified procedures requiring less extensive incisions. One such procedure is 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.
After your surgery
After surgery, you’ll wear a sport’s 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 our surgeon.
You’ll need to wear the 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. The 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.
Getting back to normal
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 do call our surgeon.
Our 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.
Your new look
Our surgeon will make every effort to make your scars as inconspicuous as possible. Still, it’s important to remember that mastopexy and breast reduction 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 and breast reduction 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 or breast reduction is likely to be greater if you understand the procedure thoroughly and if your expectations are realistic.
