Frequently Asked Questions About Breast Lift
Sometimes breast lift is performed in conjunction with the insertion of implants. This procedure is called breast lift with augmentation. Visit Breast Implants 4 You to learn about breast augmentation and to view breast implants before and after pictures.
1. What is mastopexy?
The mastopexy, or breast lift surgery, is really several different procedures, each with the intended purpose of lifting the breast up and repositioning the nipple where it was before sagging occurred.
2. Am I a candidate for mastopexy (breast lift)?
If you have no serious health conditions, are not prone to keloid scarring, have good elastic skin and have noticed that your breasts have started to sag and that the effects of aging are take their toll on your breasts, you may be a candidate for mastopexy. The ideal candidate is also mentally and emotionally stable and has realistic expectations of breast lift surgery.
3. When is mastopexy usually performed?
Women often seek out a mastopexy (breast lift) after a pregnancy or after they've lost a lot of weight, both times when there can be a lot of breast tissue loss. Sometimes drooping comes with age or from not wearing a bra. A mastopexy will transform a sagging breast to its former youthful appearance. However, if you are planning to have children, you should postpone your breast lift surgery until after you are sure you have completed your family since another pregnancy could prompt another mastopexy. A mastopexy can be performed at any age if you are in good health and meet certain emotional criteria (such mental stability and realistic expectations).
4. What does a typical mastopexy consultation entail?
At your consultation the surgeon should measure your breasts and general torso area to determine a natural and aesthetically pleasing post-op position for your breasts and areola/nipple complex. He or she should take into account your skin condition (i.e., elasticity and thickness) and age. Sometimes a surgeon will offer the option of inserting an implant to create fullness and lift. Your surgeon should also go over the details of how a mastopexy is performed, the possible risks and complications involved and any postoperative special care instructions. Be sure to ask about the scars that will result from this surgery. The surgeon should also discuss all fees involved so you're not surprised by hidden costs. The consultation is your opportunity to ask any questions and raise any concerns you may have before deciding whether to commit to mastopexy.
5. What are the different techniques for breast lift (mastopexy)?
The amount of sag (ptosis) determines the mastopexy procedure that is used. It's also important to factor in whether augmentation or reduction should accompany the lift.
When a slight amount of ptosis is present, a crescent mastopexy can be performed, often in conjunction with breast augmentation. Should a greater amount of lift be required, an incision will be needed that completely circles the areola, with a vertical line dropping down the center of the breast to the bottom of the breast. Sometimes a larger crescent incision at the bottom of the breast in the crease between the breast and the chest is also needed.
6. How is mastopexy performed?
The crescent mastopexy calls for the removal of a crescent of skin above the areola, relocating the nipple higher and suturing it into place. This creates a minor lift for patients who have slight ptosis.
The Benelli lift is considered less invasive and was designed with scars falling around the areola. With the Benelli, a doughnut-shaped piece of tissue around the areola border is removed and the surrounding tissue sutured to the areola. The incisions are normally closed with purse string sutures. Sometimes a little more tissue is removed above the areola to compensate for a lifting effect when it is sutured.
The Benelli-Lollipop is the same as the above but with straight incisions from under the areolae to the mammary folds. This technique is for women who have medium ptosis, too much for the Benelli only and too little for a full anchor incision.
A full mastopexy or full breast lift uses an anchor-shaped incision that starts at the base of the areola, vertically to the where the breast meets the rib cage. The incision then cuts out a crescent shape piece of skin right above where the breast meets the rib cage. Nipple repositioning is necessary with this technique as the nipple must be removed during the procedure. This is considered a major scarring technique that is sometimes necessary for severely sagging breasts. The scars fade in time, but do not expect them to disappear completely.
7. What should I expect postoperatively when it comes to breast lift recovery?
Sutures may have been placed underneath the skin and should dissolve over several months. Sutures placed through the skin should dissolve in 1 to 2 weeks. A special tape called Steri-Strips is usually placed over the sutures or tissue glue to help protect the wound. A bra must be worn continuously for 21 days. There is generally very little pain after this operation and only a moderate amount of swelling. The patient may return to work in 3 to 4 days unless the work involves bending or lifting.
It is quite normal to have loss of sensitivity in the nipple and breast skin due to the swelling. The swelling blocks the nerves' ability to send and receive pain and pressure messages from the brain. Most sensation returns within 1 to 3 months, although it may take a year or more.
8. Is there much pain associated with mastopexy?
Pain after breast lift surgery is normally not severe. Most often patients describe a feeling of discomfort and soreness, which your prescribed pain medications should alleviate. However, do not hesitate to call your surgeon or the staff on call if you feel your pain is severe.
You will experience more pronounced pain if you remove your support bandages and bra for longer than is necessary to sponge off. You may also interfere with the end result by going braless soon after your procedure. It is advisable to wear a bra for most of the day and evening, sleeping without it only if you must.
9. Is there a lot of swelling involved with mastopexy?
Swelling is an issue but can be lessened if the patient sleeps with the upper torso elevated and stays upright for the first few weeks. This keeps the edema (fluids) from pooling around the traumatized area. Drinking lots of water can help as well, as can decreasing your sodium intake. You may want to speak with your surgeon beforehand regarding Arnica montana, bromelain, and vitamins A, C and K to help with the healing process.
10. Where are the mastopexy scars located?
Your surgeon should attempt to make your scars as inconspicuous as possible. However, you must realize that some mastopexy (breast lift) scars are extensive and permanent. The scars will be red and raised for several months, gradually fading in color and flattening out.
The scar from the crescent mastopexy is at the junction of the areola (pigmented skin) and non-pigmented skin. It heals leaving a scar that is barely visible in most people.
The Benelli lift leaves just a scar around the areolae (darker, pigmented area), and the lollipop (or keyhole) leaves a scar around the areolae and straight down to the natural crease where your breast meets your rib cage.
The full breast lift involves more incisions. The anchor-shaped scar is normally the chosen incision line. However, different doctors have different techniques. The scars fade dramatically over the course of 12 to 24 months and are not very noticeable in many women. In others, the scars will always be somewhat visible, generally seen as a lighter area on the breast.
All women undergoing mastopexy should be certain that they understand the incisions and resulting scars. When the patient knows ahead of time what to expect, it is most likely that the scars will pale by comparison to the newly improved breast shape and placement.
11. When can I return to work?
You may not feel like doing much for a few days postoperatively, or you may be up and about, walking around and thinking you are feeling fine. In reality, you will probably still need your pain medications and possibly the option of lying down if need be. Just be sure that you do not lift anything over your head (including your arms) for at least 10 days or until your doctor specifies. Do not engage in strenuous activities, including hard labor or exercise, for at least 3 weeks. In some cases, you are not allowed to have sexual relations until at least 7 days after surgery.
12. When will I be able to see the results of breast lift surgery?
Although the breast lift results are quite immediate, you should not risk taking the bandages off to check. Your bandages will be removed in a few days at a postoperative visit and then you will switch to a soft support bra that will be worn for 21 days. Follow these instructions. Not doing so could risk improper healing and could damage your sutures. After 21 days you will more than likely be able to go without a bra, but this isn't advised. You should at least wear a bra either in the day or at night while you are sleeping. The breasts will eventually sag or lose their firmness once again as you age, but they will sag more quickly if you choose to not to support them with a bra most of the time.
13. What are some breast lift complications and risks?
There are several potential breast lift complications and risks that you may encounter postoperatively. It's possible to have a negative reaction to the anesthesia, excessive bleeding, infection, hematoma and seroma. Permanent loss of sensitivity in the nipple area and breast skin is also possible. If you smoke, your surgical risks increase and your scars will heal more slowly than a non-smoker's would.
A big fear is tissue necrosis, or tissue death. Seriously, you do not want this. Tissue necrosis happens when you have poor oxygen-tissue saturation (as often happens with smokers) or the surgeon did not use a pedicle to keep blood flowing to your nipple or other skin sections that were reattached. Necrosis is by far the most worrisome and dangerous issue, so do all that you can to keep this from happening, like quitting smoking several weeks before surgery.
Infections, although rare, can happen when naturally occurring bacteria like staph enter your incisions. That is why it is important to wash your breasts, neck and torso with an anti-bacterial soap like Hibiclens or even Dial anti-bacterial for several days before your surgery.
14. What are Arnica montana or bromelain?
Arnica montana is an herb that has been used in Europe for centuries to treat swelling, soreness and bruising. There are many formulations from different companies. Sublingual (under the tongue) types are the most often recommended for plastic surgery.
Warning: This herb should never be taken in raw form because it can cause intestinal bleeding, abdominal cramping and sickness. Homeopathy is the medicinal use of tinctures and suspensions using herbs and other plants. These substances should never be consumed without proper preparation.
Derived from the pineapple plant, bromelain is an anti-inflammatory formula containing an enzyme that dissolves proteins. It is most often used after sports injuries or surgical procedures to help with swelling.
Other products or supplements that are often recommended are vitamins A, K and C. Please discuss these with your surgeon if you are interested in them or have questions.
15. How long does a mastopexy last?
The American Society for Aesthetic Plastic Surgery classifies breast lift results as "long-lasting", not permanent. Gravity will prevail and you will sag, period. You can attempt to slow the process by wearing supportive bras, staying out of the sun and eating healthily. It may be years from now, but you may need an additional mastopexy – so be safe, wear a bra!