Breast lift, or mastopexy, restores the breast to a more youthful appearance. With age, gravity, pregnancy, breast feeding and weight gain or loss, breasts can flatten and elongate with sagging of the nipple. Exercise will tighten the pectoralis muscle beneath the breast but it will not tighten loose skin. If a patient is happy with the size of her breasts but not with sagging of the breasts, a breast lift is likely the best choice. A breast lift tightens the skin, which lifts and firms the breasts improving the shape and lifting the nipple. The areola, which is the dark area around the nipple is often reduced at the same time.
Breast lift may be performed along with a breast augmentation to create a lifted, fuller breast. This is a common procedure for patients whose breasts have sagging and volume loss after pregnancy/breast feeding or large amount of weight loss. Occasionally the breast lift and augmentation may need to be done at 2 separate procedures for safety of blood supply to the nipple and avoidance of nipple loss.
Breast lift cannot be performed without scars on the breast. The scars may be isolated around the areola for a breast with minimal sag but may also include a scar vertically on the breast and possibly under the breast for a breast with significant sag of the nipple and extra skin. The incisions used for the breast lift will depend on the amount of sag present, the position of the areola, quality of the breast tissue, and desire for simultaneous augmentation.
The incisions include an incision around the areola(periareolar), around the areola and vertically beneath the areola (vertical or lollipop), or the lollipop incision combined with an incision in the inframammary fold
( inverted “T”).
As with all cosmetic procedures, realistic expectations of short and long term results are very important before undergoing surgery. A breast lift will improve fullness in the upper part of breast but with time and continued gravity, this fullness will decrease even though the breast and nipple remain in a lifted state. If maintenance of superior fullness is also a desire, an implant will need to be used along with the breast lift as long as the patient is willing to have larger breasts. A breast lift may need to be repeated in the future to maintain optimal results especially with larger breasts. The decision to have surgery should be taken seriously and thought over carefully. Patients should always thoughtfully consider the benefits and possible complications before making an informed decision.
As with any surgery, risks include bleeding, abnormal scarring and infection. Widened scars are more common when augmentation and mastopexy are performed at the same time or if the patient is a smoker. Nipple sensory changes may occur and are usually temporary but may be permanent. Although symmetry of the breasts is always the goal, asymmetry of nipple position, shape or scars is also a possibility. Significant weight gain or loss or pregnancy and breast feeding can affect breast size and the long term results. Breast feeding can become more difficult or unsuccessful after breast lift.
Details of Surgery
Breast lift surgery lasts 2-3 hours and is performed under general anesthesia or local anesthesia with sedation. It is an outpatient procedure done in the hospital operating room. Dissolvable sutures are used so there is no stitch removal needed after surgery. Drains are very rarely used. After surgery patients are wrapped in an ace wrap or surgical bra and ace wrap. It is common to be tired and sore after surgery. Patients should be up walking around the day of surgery and may use your arms after surgery for normal daily activities including lifting your hands over your head to apply makeup, fix your hair, etc. However, excessive use of your arms such as lifting greater than 5 lbs., straining or stretching, should be avoided. Patients should have a responsible adult with them the night of surgery. A sports bra may be worn full time within a few days after surgery and continued for several weeks. Return to work may be within a few days to a week depending on job requirements. Breasts will be sensitive for a month or more.