Breast Uplift – Mastopexy
Breasts may sag due to significant weight loss or one or more pregnancies and subsequent breast feeding periods. The objective of a breast lift or mastopexy is to raise and reshape sagging breasts: this is achieved by removing excess skin and repositioning the remaining tissue and nipples to improve the breast’s appearance. A breast lift can also reduce the size of the areola, i.e. the darker skin surrounding the nipple. If a patient’s breasts are small or have lost volume, one option is to combine breast implants with the breast lift.
It is advisable that you first discuss this procedure with your General Practitioner (GP), who may then refer you to the Consultant Plastic Surgeon of your choice. Sharing your expectations with your GP and surgeon is the best way to increase the possibility of achieving your desired outcomes.
Breast lift surgery will make your breasts firmer and more uplifted. The position of your areolas and nipples will be improved, and the size of your areolas will be aesthetically pleasing. The incisions from your breast lift surgery will heal and fade over time. It is important to realize, however, that the incision lines will be permanently visible. In some instances, they will eventually be only faint lines. Certain individuals may have incision lines that are more noticeable. Fortunately, the incisions for your breast lift are in locations easily concealed by clothing, even low-cut necklines.
Unless you gain or lose a significant amount of weight or become pregnant, your new breast shape should remain fairly constant. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman’s breasts. You are advised to wear a bra as breasts, which contain no muscles and therefore cannot be exercised, will be pulled down by gravity and larger breasts will tend to sag. If, after a period of years, you again become dissatisfied with the appearance of your breasts, you may choose to undergo a second breast lift procedure to restore their more youthful contour and appearance.
During the consultation, you will be asked about your desired breast shape and size. Your Consultant Plastic Surgeon will discuss with you how your nipples and areolas will be repositioned. You should mention anything else about your breasts that you would like to see improved. This will help your Consultant Plastic Surgeon to understand your expectations and determine if they realistically can be achieved.
Your Consultant Plastic Surgeon will examine your breasts, taking measurements and photographs for your medical record. The size and shape of your breasts, the quality of your skin, and the placement of the nipples and areolas will be carefully evaluated. You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries including breast biopsies, and medications that you currently take. It is important for you to provide complete information.
You should tell your Consultant Plastic Surgeon if you plan to lose a significant amount of weight, particularly if you have noticed that your breasts sag or become smaller with weight loss. Your Consultant Plastic Surgeon may recommend that you stabilize your weight prior to surgery. Individual factors and personal preferences will determine the specific technique selected to lift your breasts.
The procedure for a breast lift is similar to that for breast reduction although usually involves smaller scars. A common method of lifting the breasts involves three incisions. One incision is made around the areola. Another runs vertically from the bottom edge of the areola to the crease underneath the breast. The third incision is horizontal beneath the breast and follows the natural curve of the breast crease.
Incisions following the breast’s natural contour define the area of excision and the new location for the nipple and areola. After the Consultant Plastic Surgeon has removed excess breast skin, the nipple and areola are shifted to a higher position. The areola, which in a sagging breast may have been stretched, can be reduced in size. The nipples and areolas remain attached to underlying mounds of tissue, and this usually allows for the preservation of sensation and the ability to breast-feed.
Once the nipple/areola are repositioned, skin that was previous above and adjacent to the areola is brought in and used to reshape the breast.
There are many variations to the design of the incisions for breast lift surgery. The size and shape of your breasts, size of your areolas, and extent of sagging are factors that will help your Consultant Plastic Surgeon determine the most suitable technique for you.
In some instances, it may be possible to avoid the horizontal incision beneath the breast. Sometimes a technique may be used that avoids this horizontal incision as well as the vertical incision that runs from the bottom edge of the areola to the breast crease.
Ideally your breast lift surgery should be performed in a major hospital. Medications are administered for your comfort during the surgical procedure. Usually, a general anaesthetic is administered, so that you will be asleep throughout the procedure.
When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Sometimes, small drain tubes will have been placed in your breasts to help avoid the accumulation of fluids. Gauze or other dressings may be placed on your breasts and covered with an elastic bandage or surgical bra. You usually have to stay a minimum of one night in the hospital after your operation.
The day after surgery, you will be encouraged to get out of bed for short periods of time. After several days, you should be able to move about more comfortably. Straining, bending and lifting must be avoided, however, since these activities might cause increased swelling or even bleeding. You may be instructed to sleep on your back to avoid pressure on your breasts.
Any surgical drains will be removed within a few days of surgery, at which time your dressings may also be changed or removed. You may be instructed to wear a support bra for a few weeks, until the swelling and discoloration of your breasts diminish. Generally, stitches will be removed in stages over a period of approximately three weeks, beginning about one week after surgery. You should be careful not to stretch your arms too high over your head as this may put undue stress on the stitches. Your breasts may also require some time to assume a more natural shape. Incisions will initially be red or pink in colour. They will remain this way for many months following surgery.
You may notice that you feel less sensation in the nipple and areola areas. This is usually temporary. It may, however, take weeks, months or even more than a year before sensation returns to normal.
All operations involve potential complications:
- Bruising and swelling are commonplace but usually last for approximately two weeks but can continue for a month or more.
- Although uncommon, bleeding and infection are possible risks and can be serious.
- You will have pain and discomfort after the mastopexy although the pain is temporary and usually only lasts for a few days.
Remember that the human body is asymmetrical and that even after surgery both sides of the body will look different and there may be some change in the shape of the breast over time.
At the time of surgery the small nerves that supply feeling to the skin are damaged. This may cause changes in sensation including numbness.
Specific potential complications relating to mastopexy include: loss of the nipple due to poor blood supply, persistently heavy scarring and an inability to breast feed.
Approximately one per cent of all operations lead to major complications. Potentially serious complications such as a blood clot or embolus or an unexpected response to drugs or anaesthetics, although extremely rare, can occur.
Please note: that with all procedures there is a possibility of patient dissatisfaction with the outcome.
A fundamental part of surgery is the need for an incision: the severity of visibility of scars left after the incision are dependent on your physiology and the Consultant Plastic Surgeon’s expertise. In most patients the scar heals well, but in a small number of people the scar remains thick and heavy.
Allergic reaction to anaesthetic
In very rare cases anaesthetics can cause allergic reactions. The best current estimate is that a life-threatening allergic reaction (also known as anaphylaxis) happens during one in 10,000 to one in 20,000 anaesthetics. Your anaesthetist will choose the drugs for your anaesthetic by taking into account many different factors, in particular, the type of operation, your physical condition, and whether you are allergic to anything.
Most people make a full recovery from anaphylaxis. It isn’t known how many anaphylactic reactions during anaesthesia lead to death or permanent disability. One review article suggests that one in 20 serious reactions can lead to death. This in effect implies that the chance of dying as a result of an anaphylactic reaction during anaesthesia is between one in 200,000 and one in 400,000 anaesthetic procedures.
For additional information regarding this procedure please contact your Consultant Plastic Surgeon.