ARE YOU CONSIDERING A BREAST LIFT?…
As you age, pregnancy, nursing, and the force of gravity take their toll on your breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. Breast lift, 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. We can’t answer all of your questions here, since a lot depends on your individual and clinical circumstances. Please be sure to see Dr Dolynchuk if there is anything else 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.
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.
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 our 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 combined augmentation mastopexy as well as smokers.) The procedure can also leave you with unevenly positioned nipples, or a permanent loss of feeling in your nipples or breasts, as well as firmness which was previously not noticeable to you.
PLANNING YOUR SURGERY
In your initial consultation, it’s important to discuss your expectations frankly with us, and to listen to our opinion. Every patient–and every physician, as well–has a different view of what is a desirable size and shape for breasts.
Dr. Dolynchuk will examine your breasts and measure them while you’re sitting or standing. He 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.
He will describe the procedure in detail, explaining its risks and limitations and making sure you understand the scarring that will result. He will also explain the anesthesia to be used, and the type of facility where the surgery will be performed. His staff will discuss the costs involved.
Don’t hesitate to ask us 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, we 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 a hospital, or an outpatient surgery center. It’s usually done on an outpatient basis, for cost containment and convenience. If you’re admitted to the hospital as an inpatient, you can expect to stay one or two days.
TYPES OF ANESTHESIA
Breast lifts are usually 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.
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 or a lollipop-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 possibly 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 and then a surgical bra. 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.
Within a day, a soft support bra will replace the bandages, and the doctor in your home will remove the drains placed at surgery. You’ll need to wear the support bra around the clock for three to four weeks, over a layer of paper tape. The stitches will dissolve after three to six weeks.
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
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 the office.
We will give you detailed instructions for resuming your normal activities. You will 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.
Dr Dolynchuk will make every effort to make your scars as inconspicuous as possible. They often remain lumpy and red for months. They then gradually become less obvious, sometimes eventually fading to thin white lines. An additional procedure is sometimes required to achieve fine flat scars. 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.
ASPS, founded in 1931, is the largest plastic surgery organization in the world and the foremost authority on cosmetic and reconstructive plastic surgery. Dr Dolynchuk is a physician member of the ASPS and is certified by the American Board of Plastic Surgery (ABPS) and the Royal College of Physicians and Surgeons of Canada.