Pregnancy, nursing and gravity can cause your skin to lose its elasticity, resulting in the breast to lose its shape and firmness and begin to sag. A breast lift, or mastopexy, raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour. If your breasts are small or have lost volume, implants may be inserted in conjunction with a breast lift to increase your breast volume.
About the Procedure
A woman’s breasts often change over time, losing their youthful shape and firmness. These changes and loss of skin elasticity can result from:
- Weight fluctuations
Also known as mastopexy, a breast lift raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour.
Sometimes the areola becomes enlarged over time, and a breast lift will reduce this as well. A breast lift can rejuvenate your figure with a breast profile that is youthful and uplifted.
What it won’t do
Breast lift surgery does not significantly change the size of your breasts or round out the upper part of your breast. If you want your breasts to look fuller or smaller, you might want to consider either breast augmentation or breast reduction surgery.
Is it right for me?
Breast lift surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.
A breast lift is a good option for you if:
- You are physically healthy and maintain a stable weight
- You do not smoke
- You have realistic expectations
- You are bothered by the feeling that your breasts sag, have lost shape and volume
- Your breasts have a flatter, elongated shape or are pendulous
- When unsupported, your nipples fall below the breast crease
- Your nipples and areolas point downward
- You have stretched skin and enlarged areolas
- One breast is lower than the other
Your consultation is your time to ask the doctor about the procedure you’re considering, how he thinks it will work for you and any concerns you may have. We suggest you come prepared with your questions on paper so you’re sure not to forget to ask the questions that are important to you.
Questions to consider:
What is the simplest and safest surgery to help me achieve my goals?
How is the surgery performed?
What is the expected length of operation?
Are other options available?
What results can I expect, and how long do the typical results last?
Where will scars be located, and how noticeable will they be?
Will scars fade over time, and how long will this take?
When you arrive at the office, you will be asked to fill out a few pieces of paperwork. It is very important when asked about medications to put down all medications you take, including any supplements or aspirin-type regimens, since these items can impact your blood clotting and pressure. In addition, you need to be truthful about your use of tobacco and alcohol since this will affect your recovery and incision healing.
Before you see the doctor, a nurse or nurse practitioner will do an initial exam. You may be able to get a number of your questions answered while with the nurse.
Your surgeon will discuss several factors regarding surgery during your initial consultation, including your procedure, location, anesthesia and recovery. In addition, the surgeon will inquire about your concerns, priorities and motivations for pursuing surgery, as well as your fears.
The doctors are sure to address reasonable expectations for the outcome of your desired procedure, and they should explain what is possible and what is not possible.
After your consultation with the physician, you will meet with the practice manager to discuss procedure costs.
There are a number of things to do prior to your procedure that will make your recovery as smooth as possible and ease your pre-procedure anxiety.
Your surgeon will give you instructions on what medications to stop taking and when prior to your surgery to prevent any unwanted side effects. Medications you shouldn’t take up to two weeks prior to your surgery include, but are not limited to, aspirin and products containing aspirin, alcohol and herbal supplements. Your surgeon may advise you to take Arnica Montana, Bromelain or vitamins A or K for swelling, bruising and to promote general healing.
It is important to remember to only take a supplement or herbal remedy if your surgeon advises it.
Your Pre-Op Checklist
- Take pictures and make notes to discuss with your doctor. You know what you want, and he knows how to make it possible.
- Make a list of post-op projects and gather what you need. Stop taking blood-thinning medications and supplements two weeks prior to surgery (aspirin, Motrin, fish oils, vitamin E) and don’t take them two weeks after surgery.
- Start using anti-bacterial soap in the shower a few days before surgery and following surgery.
- Remove all fingernail and toenail polish.
- Fill prescriptions you’ll need, including antibiotics and pain medications.
- Purchase over-the-counter eye drops and eye gel for overnight (GenTeal seems best and it is found at major drug stores like Walgreens)
- Pick up Bacitracin for incision areas and Colace to keep your bowels moving during recovery.
- Clear your calendar for a month post-op.
- Arrange for caretakers: you, kids, plants and pets need to be taken care of during your recovery. You will not be able to lift, reach, bend over or be too active for some time.
- Prepare your recovery area so your head is elevated. A recliner works wonders for this. Also stock your recovery area with blankets, water, phone, lotion, tissues, remote control, reading material, laptop, etc.
- Make a to-do list of things you want to get done prior to surgery and start! You won’t be able to accomplish as much post-surgery. Some items you may want to get done include:
- Stock up on groceries and easy to prepare meals
- Clean the house
- Catch up on gardening
- Give the dog a bath
- Clean the litter box
- Wash your car
- Stock up on ice packs, frozen peas and frozen gel packs. You’ll want to use them early and often on your face, neck and ears. It will definitely feel good and keep the swelling down.
- Pack a receptacle with a lid and towel in your car for the ride home from the hospital just in case you feel nauseous. You may want to add a pillow and blanket, but be sure to set up on the ride home to help with the nausea and swelling.
- Get your hair and nails done since it will be a while before you can do either.
- Prepare Power of Attorney for Medical Care and Advance Directives, just in case. Give copies to your doctor and/or surgical center.
- Breathe and relax! Stress can adversely affect your recovery. Try to remember that you will heal, the soreness will subside and you will look great.
During Your Procedure
Your breast lift surgery can be achieved through a variety of incision patterns and techniques.
The appropriate technique for you will be determined based on:
- Breast size and shape
- The size and position of your areolas
- The degree of breast sagging
- Skin quality and elasticity as well as the amount of extra skin
Anesthesia: Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
The Incision: There are three common incision patterns
Around the areola
Around the areola and vertically down from the areola to the breast crease
Around the areola, vertically down from the breast crease and horizontally along the breast crease
Reshaping Your Breasts – 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.
Closing the Incisions: 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 lift 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.
The final results of your breast lift will appear over the next few months as breast shape and position continue to settle. Incision lines are permanent, but will continue to fade over time.
The results of your breast lift surgery will be long-lasting. Over time, your breasts can continue to change due to aging and gravity. But, you’ll be able to retain your new look longer if you:
- Maintain your weight
- Keep a healthy lifestyle
Special note: While a breast lift does not usually affect breast function, if you are planning to become pregnant, discuss this with your plastic surgeon. Changes that occur in the breasts during pregnancy can minimize or reverse the improvement a breast lift provides. Likewise, plans for significant weight loss should also be discussed.
After your breast lift procedure is completed, dressings or bandages will be applied to the incisions. You’ll need to wear an elastic bandage or support bra to minimize swelling and support your breasts as they heal.
A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.
Recovery is an important part of any surgery, and you must take the doctor’s orders to heart if you want to heal as quickly as possible.
You will be given specific instructions that may include: how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in overall health, and when to follow up with your plastic surgeon.
Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.
- Where will I be taken after my surgery is complete?
- What medication will I be given or prescribed after surgery?
- Will I have dressings/bandages after surgery? When will they be removed?
- Are stitches removed? When?
- When can I resume normal activity and exercise?
- When do I return for follow-up care?
Risks are associated with any surgery. Risks that you need to discuss with your surgeon include:
- Unfavorable scarring
- Bleeding (hematoma)
- Poor healing of incisions
- Changes in nipple or breast sensation, which may be temporary or permanent
- Anesthesia risks
- Breast contour and shape irregularities
- Skin discoloration, permanent pigmentation changes, swelling and bruising
- Damage to deeper structures such as nerves, blood vessels, muscles, and lungs can occur and may be temporary or permanent
- Allergies to tape, suture materials and glues, blood products, topical preparations or injected agents
- Breast asymmetry
- Fatty tissue deep in the skin could die (fat necrosis)
- Fluid accumulation
- Excessive firmness of the breast
- Potential partial or total loss of nipple and areola
- Deep vein thrombosis, cardiac and pulmonary complications
- Blood clots
- Pain, which may persist
- Possibility of revisional surgery
You should know that:
- Breast lift surgery can interfere with diagnostic procedures
- Breast and nipple piercing can cause an infection
- Breast lift surgery does not normally interfere with pregnancy, but if you are planning to have a baby, your breast skin may stretch and offset the results of mastopexy and you may have more difficulty breastfeeding after this operation.