The APSI Guide to Breast Lift Surgery

 

Breast Lift Surgery

Breast lift surgery (also known as a mastopexy) is a procedure done to tighten the skin of the breast and raise the position of the nipple back into an ideal spot.  It is a frequently desired surgery due to the changes that occur to the breast as a result of aging, weight loss, or breast feeding.  Women may notice some droop to the breast and communicate a desire to ‘tighten’ or ‘lift’ the breast back into its normal position and contour.

 

 

What is a breast lift and what does it achieve?

Breast lift surgery holds up to its name.  The surgeon creates incisions in the skin of the breast and removes and tailors some of the skin in order to reshape and tighten the skin envelope.  The breast tissue and fat is not removed.  The amount of skin removed may just weigh a few ounces.  The nipple and surrounding areola is placed in a new, higher location on the breast mound without the nipple being cut from its underlying blood supply.  The areola is downsized if needed for a better appearance.   Having a plastic surgeon perform a breast lift is much like having a tailor take out a pleat of extra fabric.  Attention is turned to tailoring the skin optimally so that the skin has the right drape over the breast tissue.

 

Candidates for breast lift

The best candidate for a breast lift is a woman who is close to their ideal weight (ideally with a BMI or body mass index less than 30) who is happy and stable at her weight.  The patient generally has an unhappiness with the appearance of the droop of the breast but is otherwise happy with the size of the breast.  The patient will frequently say that they like the appearance and volume of their breasts in a non-padded but lifting bra.   The patient is best served when expectations of her body are reasonable.  Expectations may not be met if the patient believes that the lift will achieve the appearance of an implanted breast.  If the patient has very little breast tissue and truly desires more volume, then a lift and augmentation may be needed.  The patient also has to accept that scars are the tradeoff for the improvement in appearance.  The scar may vary from a scar around the areola, to a ‘lollipop’ configuration, or to a standard Wise pattern (or anchor type) scar depending on how much excess skin exists.   Based on measurements during your examination, your surgeon will be able to explain how the skin is removed (in what pattern) and describe the type of scar lines you will be expected to see as a result.  The lower the nipple position, the more skin that requires tailoring, and the higher the likelihood will be that you need the anchor type scar.  But, with more skin excision, the more dramatic and fulfilling the result!

 

An Important Truth About Breast Lift Surgery

Although the fat and breast tissue is left behind during a breast lift and only a small amount of weight is removed in the form of skin, the breast may appear slightly smaller to the patient after a lift.  When a breast has some droop, the patient views a long appearing breast in the mirror.  After the lift, the vertical height of the breast is shortened.  The breast fits differently in a bra and may seem slightly smaller appearing in clothes.  It is important that the patient understands this preoperatively especially if they would be unhappy with a slightly smaller breast.  

 

Surgery

The surgeon meets with you before surgery and typically draws on your skin to indicate the new position of the nipple and where the skin is removed.  The surgery is frequently done under general anesthesia and takes somewhere between 1-2 hours depending on how much skin tailoring is required.  It may take longer if any implant is also placed during the same surgery.  The patient recovers for 1-2 hours on average after the surgery and then goes home.

 

What to expect after surgery

Patients go home after this outpatient surgery and need a trusted friend or family member to drive them and stay with them overnight.  Alternative options for this include some trusted nursing care to fill this role.  You may be required to return to clinic within a day or two for a quick postoperative check. For the most part, this surgery has low associated pain levels since it only involves the skin of the breast.  Patients have varied pain thresholds, but most patients require some occasional narcotic pain medication for a few days after surgery.  For this reason and ongoing discomfort, they are not safe to drive initially but can be quite functional at home preparing meals for themselves and walking and showering unassisted.  Many people are able to go back to work within a week or so.   All patients describe soreness, swelling, and some degree of bruising after surgery.  This always improves gradually.  Some patients note some occasional tingles or shooting pains as a normal part of the healing process.  Numbness to the nipple area is frequently a temporary issue although there is a small risk of significant and persistent numbness in that area.  During the first few weeks it will be important to wear a softly supportive bra which patients initially wear even at night for the first 2 weeks.  There will be activity and weight lifting restrictions initially that are communicated to you via your surgeon or staff.  These restrictions are important as they promote healing and reduce the risk of complications such as fluid collections or bleeding.  We want all patients up and walking to avoid the risk of DVT or blood clots as with any surgery.  Patients will be back to showering quickly and most everyday types of activities within 48 hours.  There is very little aftercare involved with the incisions and any suggested scar treatment will be discussed with you.   Your surgeon will see you back to assess your healing and shape.  Scars will take time to soften and fade.  Photos are a necessary way to track your result since your change in contour is best appreciated with photography.

 

Risks

Risks will be reviewed with your surgeon but include infection, prolonged pain, poor scars, prolonged numbness, asymmetry, hematoma-bleeding, fluid collection, poor healing, unsatisfied cosmetic expectations, and need for further procedures or revision.   This surgery is not done on active smokers or those consuming nicotine products as the healing of the skin can be significantly impeded by such exposure.  Please be honest with your surgeon about your use of such products!  We are not here to judge you.  We are here to protect your result and healing potential.

 

Thank you for reading our article.  Breast lift surgery can be a very satisfying experience and a huge boost in confidence for our patients.  If you are interested, please make sure to schedule a consult with one of our board certified plastic surgeons today!

Author credit: Lauren Crawford, MD 

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