What are the benefits?
Breast lift surgery makes the breasts firmer and more shapely. Many women find that they no longer need to wear a bra to feel comfortable and look good in their clothes.
What will happen at the consultation?
During the consultation, you and your surgeon will discuss the changes that you would like to make in your appearance. Your doctor will explain the procedure, including what kind of anaesthesia he will be using. At this time, he will also ask about your medical history, and perform an examination. You should stop smoking 6 weeks prior to surgery and 2 weeks afterwards.
How is the procedure performed?
Several different techniques can be used to correct this condition, depending on the degree of sagging. Surgery consists of removing excess skin from around the areola, and possibly also from the bottom of the breast, with shifting of the skin of the breast to tighten the skin envelope. In doing so, the position of the nipple and areola can be elevated to a more youthful position.
The specific breast lift techniques may vary, but they generally fall into two categories: the concentric (or doughnut) mastopexy for women with smaller and less droopy breasts and the more common anchor-shaped mastopexy. In general, the more tissue that is cut, the more shaping is possible. This means that in women with extensive sagging, the skin has stretched so much that a smaller incision will not remove enough tissue to lift the breast. In these cases, the larger incision is necessary.
- The Concentric (doughnut) Mastopexy
For women with smaller and less severely drooping breasts, this procedure (which requires fewer incisions) may be possible. Concentric circles (like a doughnut) around the areola are drawn and cut. The doughnut-shaped skin around the areola is removed and the nipple and areola are moved upwards. Then the outer skin is stitched (sutured) around the areola.
Sometimes the skin that is stitched to the areola may wrinkle because there is more skin than needed around the areola. Often the wrinkling will subside in just a few weeks to months after surgery as the skin envelope adapts to the new shape and weight of the tissues. If your surgeon does not think that this is possible he may instead elect to make a cut that descends from the areola down to the bottom fold of the breast where it meets the chest. A strip of skin is removed along this cut and the two sides stitched together. Even with this additional vertical cut, this procedure leaves less scarring than the more common anchor-shaped mastopexy.
- Anchor-shaped Mastopexy
For women with larger or more severely drooping, sagging breasts, the anchor-shaped mastopexy is more effective.
The physician will draw a keyhole shape above the nipple and areola. At the bottom of the keyhole, he will draw an anchor shape from the right to the left side of the breast. The skin in the area of the 'anchor' will be removed possibly along with some excess breast tissue. The nipple and areola are moved up to the 'key-hole', then the skin is sutured (stitched) around the areola, vertically down to the chest and side to side along the newly created bottom fold of the breast.
How long does the operation take?
Breast lift surgery usually takes about three to four hours to complete. The length of the procedure varies according to the technique used.
How long do I have to stay in the hospital for?
Most breast lift surgery is performed as an in-patient with one or two nights stay. It is performed under general anaesthesia.
What can I expect afterwards?
Your breasts will probably be sore for two or three days. The pain is greatest within the first 48 hours, but improves with each day and is usually relieved by pain medications.
After the operation, you will notice an immediate and dramatic change in the shape of your breasts. Most women are very pleased immediately after surgery. Some numbness is normal after surgery and may persist permanently, but almost all women feel that it is worth it. You may have a drain in place on each side for 24-48 hours. You must avoid an underwire bra as it may cause a blister on the delicate postoperative tissues.
The stitches are dissolvable so do not need to be removed after the surgery. Your breasts will be bruised, and you may experience temporary numbness around the nipples as well as random shooting pains. These conditions generally subside within several weeks.
For the first few days, you need to limit your activities and movement in order to prevent breaking the stitches and stretching the scars. Most women can return to work about two weeks later, although overhead lifting and strenuous movements should be avoided for several weeks to ensure proper healing.
Most bruising, swelling, shooting pains and loss of sensation should subside within three to six weeks. However, it may take up to a year for your breasts to settle into their new look and feel. Over time, your scars will fade but may remain red and bumpy for many months.
After the surgery, the breasts are fuller and more shapely. The surgery is designed to minimize scarring, and although scars are possible, the surgery generally results in faint lines where the surgical incisions were made. You may also notice slight size or shape differences between your breasts. It is important to keep in mind that the body is never completely symmetrical.
What are the long-term results?
A breast lift will not keep you firm forever. Your breasts will be more youthful and full than they would have been without the surgery. However, the effects of gravity, pregnancy, and weight changes will continue to affect your breasts over time.
What are the risks?
Breast lift (mastopexy) is fairly safe, but no surgical procedure is completely risk free. Risks specific to breast lift surgery include:
- permanent and noticeable scarring
- uneven nipples, mismatched breasts
- sores or numbness around the nipples
- rarely, death of tissue around the nipple and areola (especially in smokers)
- haematoma (a collection of blood under the skin)
Additionally, there are risks associated with any surgery such as bleeding, infection, or adverse reaction to anaesthesia. Perhaps the most common risks are the quality of healing and your acceptance of the resulting scars. With a breast lift, the most significant trade-off for better-positioned breasts is the appearance and permanence of the surgical scars that may take some time before they flatten and become pale.