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 breasts. 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--at
least, for a time.
(No surgery can permanently delay the effects of gravity.)
Mastopexy can also reduce the size of the areola, the darker
skin surrounding the nipple. 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. If you're considering a breast lift,
this brochure will give you a basic understanding of the procedure--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 your doctor if there is anything about the procedure you
don't understand.
The Best Candidates for Breast Lift
A breast lift 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 your surgeon.
The best candidates for mastopexy 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.
All Surgery Carries Some Uncertainty and Risk
A breast lift is not a simple operation, but it's normally
safe when performed by a qualified plastic 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 are uncommon, but they can cause scars to widen.
You can reduce your risks by closely following your physician's
advice both before and after surgery.
Mastopexy does 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 your 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 breasts 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.
Your 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 your 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, your surgeon 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, 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.
Where Your Surgery Will Be Performed
Your breast lift may be performed in an outpatient surgery
center or a surgeon's office-based facility. It's usually
done on an outpatient basis, for cost containment and convenience.
Types of Anesthesia
Breast lifts may be performed under general anesthesia, which
means you'll sleep through the operation. In selected patients--particularly
when a smaller incision is being made--the surgeon may use
local anesthesia, combined with a sedative to make you drowsy.
You'll be awake but relaxed, and will feel minimal discomfort.
The 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.
After Your Surgery
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 your surgeon.
Within a few days, the bandages or surgical bra will be replaced
by a soft support bra. You'll need to wear this bra around
the clock for three to four weeks, over a layer of gauze.
The stitches will be removed after a week or two.
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.
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.
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 to call your surgeon.
Your 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
Your surgeon will make every effort to make your scars as
inconspicuous as possible. Still, it's important to remember
that mastopexy 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 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 is likely to be greater
if you understand the procedure thoroughly and if your expectations
are realistic.
