Breast Surgery – Breast Lift
What Is Breast Lift?
Breast Lift surgery, or Mastopexy, is designed to restore a more youthful appearance to a woman’s breasts. Over the years, the breasts can lose their shape and firmness due to pregnancy, nursing, loss of skin elasticity, and the natural process of atrophy of the breast tissue after the child-bearing years, or with weight loss. This may cause the breasts to sag and to lose their shape, appearing “deflated”, especially in the upper chest. In these cases, there is a discrepancy between the skin envelope of the breast, which is excessive, relative to the remaining volume of breast tissue, which may be either adequate or deficient, in the view of the patient. Breast Lift, also referred to as Mastopexy, is a surgical procedure to raise and reshape breasts—slowing or reversing the effects of aging and gravity. This procedure can also reduce the size of the areola, the darker skin surrounding the nipple, which often becomes wider after breast feeding. If needed, a breast implant can also be placed, in order to add or restore the necessary volume to the breast, in addition to the lifting and tightening of the breast envelope.
Dr. Cambre carefully considers your expectations and the physical characteristics of your breasts to help you determine the appropriate choice of procedure for your particular circumstance. Realistic expectations are important, since the effects of gravity, loss of breast tissue volume, and loss of skin elasticity continue to change over the course of time, and results cannot be expected to be permanent. The best candidates for Mastopexy are healthy young women with small, sagging or drooping breasts. Pregnancy and nursing, with subsequent atrophy or loss of breast tissue volume, often result in stretched skin and therefore decreased volume relative to the amount of skin envelope of the breasts. Similarly, repetitive cycles of weight gain and loss may result in a breast which is of adequate cup size, but which appears too droopy. Breasts which are larger and heavier (more breast tissue volume relative to the amount of excess skin), or “empty breasts” (those with extreme excess skin and poor elasticity relative to the volume of breast tissue) can also be lifted, but the results are generally not as long lasting in these cases. Mastopexy is often performed in conjunction with Breast Augmentation (Breast Enlargement using implants) to increase breast firmness and size (volume). This may appeal to women who have lost breast volume and firmness after pregnancy or weight loss.
Dr. Cambre will take a complete medical history and conduct a careful examination to evaluate your general overall health, as well as performing a thorough examination and measurement of your breasts. Ideally, the Mastopexy patient has no health problems, no pre-existing breast disease, and wishes only to improve the shape and appearance of the breast. Mastopexy generally does not interfere with the ability to breast feed, if future pregnancies are anticipated.
Photographs will be taken before and after surgery. Most patients will be required to have a recent normal mammogram (within 6 months prior to the procedure), or we will arrange for a screening mammogram to be done prior to surgery.
Dr. Cambre will discuss your options, based upon your preferences, the physical characteristics of your breasts, and whether the addition of an implant is advisable, if you are willing to consider it. The probable location of the incisions will also be discussed with you, as well as the potential risks and complications.
Antibiotics will be prescribed prior to surgery to prevent infection. To minimize the possibility of excess bleeding, you will need to avoid taking drugs containing aspirin. You may also be advised to shower with an antiseptic soap for a day or two prior to surgery.
Mastopexy is most commonly performed in an outpatient facility setting. Breast Lifts are usually performed under general anesthesia, so that there is no pain or discomfort during the procedure.
The surgery may take between 2 to 3 hours. A common approach involves an incision along the natural contour of the fold beneath the breast where excess skin will be removed. The nipple and areola are then re-positioned higher on the breast mound. The skin surrounding the areola is brought together to reshape the breast, with stitches around the areola and the lower breast area.
Several layers of hidden sutures are used, and the final incisions are covered with surgical tape. Often, a small suction drain is placed behind the breast to avoid fluid accumulation, which is usually removed within 2-5 days.
You will be placed in a soft bra and/or a comfortable wrapping around the chest and breasts for the first 24-48 hours after surgery. Your dressings will be removed and replaced in the office at that time.
Options and Alternatives
There are other variations of the breast lift or Mastopexy technique, including “minimal incision” techniques (Binelli or doughnut Mastopexy, concentric Mastopexy, SPAIR mammaplasty, vertical or LeJour Mastopexy, crescent Mastopexy, etc.), which are generally designed to modify the length or location of the surgical scars. These techniques are not applicable in many cases, and may involve trade-offs, such as the possibility of “gathering” or puckering of the skin surrounding the areola, or delayed incision healing and poor initial shape of the breasts following surgery. Some techniques depend upon the use of implants to achieve optimal results. Although many patients initially express concern regarding the length and location of the scars, most patients are extremely pleased with their results following surgery, and they consider the cosmetic improvement of the breasts following Mastopexy to be well worth the trade-off of the necessary scars. Dr. Cambre will explain your options in detail prior to the performance of your operation.
Anyone considering any type of surgery should be aware of both the benefits and risks. Fortunately, significant complications from Mastopexy are infrequent, and patients are generally quite pleased with the results.
Potential risks of Mastopexy include bleeding, infection, and reactions to anesthesia. There may rarely be tissue loss and delayed wound healing along portions of the incision, especially in cases where the procedure has been extensive, or in smokers and diabetic patients. This may result in a widening of the scars. Mastopexy does leave permanent scars, although most of the necessary incisions are placed within natural skin folds, and all incisions are generally covered by a bra or bathing suit. The appearance of the scars can be expected to improve with time. Occasionally, the scars will require revision at a subsequent procedure, if they have healed poorly. Very rarely, problems with the shape or position of the nipples or permanent loss of sensation or loss of tissue in the nipples, or breasts, may occur. If breast implants are to be used, the complications of deflation (saline), rupture (silicone), capsular contracture, palpable surface irregularities, asymmetry, interference with mammography, and others, are also applicable (refer to Breast Augmentation on this site).
Most of the risks associated with Mastopexy can be lessened and managed by carefully following the recommendations and instructions you will receive during your consultation with Dr. Cambre. Any of your personal questions or concerns can be addressed at that time as well.
After surgery, your stitches will be covered with gauze and a soft wrap or a surgical bra will hold the bandages in place. Your breasts may be slightly bruised or swollen, and you may experience some mild discomfort for a couple of days. Dr. Cambre will prescribe pain medication strong enough to counteract any pain or discomfort you may feel. After a few days, you will be changed to a soft surgical bra. In the recovery stage, it is important to wear the bra at all times, in order to support the breasts following surgery, and to maintain their shape during healing. If drains are placed, they will be removed after 2-5 days.
After a week or two, the stitches will be removed. Dr. Cambre utilizes a special suturing technique to avoid stitch marks and to insure that incisions will eventually fade and become less obvious. You may experience a temporary loss of feeling in your nipples or breasts, which is generally caused by swelling during the initial post-operative period of six to twelve weeks. Normal sensation usually returns after three to six months.
To ensure proper healing, follow the detailed instructions you will be given at the time of your pre-operative consultation. Most patients may return to normal daily activities within 24-48 hours. You may resume non-strenuous work within one week or less following the surgery. You should avoid lifting heavy objects for 3-4 weeks and you may gradually resume strenuous physical exercise after approximately three to four weeks.
Our patients generally find Mastopexy to be an extremely “uplifting” procedure. They are enthusiastic about the restoration of a more youthful appearance to the breasts, which often appear to have aged disproportionately to the rest of their bodies. In many cases, patients are able to wear more revealing clothing, and are able to select from a wider and more appealing variety of bra styles. Many patients also report feeling more self-confident about the appearance of their breasts when not wearing clothing. In summary, the great majority of patients are very pleased with the results of Mastopexy, especially when they are well-informed regarding their options, and realistic in their expectations.
Q: How long will it take for my scars to fade?
A: Dr. Cambre will carefully monitor the progress of your incisions after surgery. There are several treatments we may recommend in order to improve the appearance of the scars and to hasten their improvement. Generally, you will see the final result of your incisions after 12-18 months.
Q: Will I lose sensation in my nipple?
A: Nipple sensation is generally preserved, although some decrease in sensation or occasionally hypersensitivity, may occur.
Q: Can I breast feed after Mastopexy?
A: Since few incisions are made in the glandular substance of the breast during Mastopexy, most women retain the ability to breast feed. However, not all women are able to breast feed, either with or without Mastopexy.
Q: Will my nipple be removed during the procedure?
A: The nipple stays attached to the breast and chest wall at all times during the procedure. This maintains the circulation and sensation to the nipple, as well as the function of the nipple and breast. The nipple is never detached from the breast, but it is transposed to a higher position on the breast mound.
Q: Does smoking increase my risk of complications from Mastopexy?
A: You must quit smoking for at least 2-3 weeks before, and 4-6 weeks after your Mastopexy. The risk of tissue loss in the nipple or surrounding breast, as well as the risk of delayed wound healing and poor scars, is much greater for smokers.
Q: When can I resume normal activities?
A: You may begin driving, return to work, and resume normal social activities within 24-48 hours if you are not experiencing too much pain, or using narcotic pain medications. You may walk and resume light lower body cardio fitness (e.g. treadmill, stationary recumbent bicycle within 48 hours. Avoid strenuous upper-body exercise for 2-3 weeks. Generally, you should avoid any activity that causes you discomfort.
Q: When can I shower or bathe?
A: You may shower after the first office visit / dressing change, generally within 24-48 hours after surgery. You must not bathe or immerse the incisions or drain sites under water in a bathtub, hot tub, swimming pool, etc. until any drains have been removed and the incisions are completely healed. Dr. Cambre will instruct you when bathing is permitted.
Q: When can I wear bras or clothing styles I prefer?
A: You can expect that most of the post-operative swelling of your breasts will be resolved after three to four weeks. At this point, the breasts are not likely to change much in size, but they may continue to soften and improve in shape. You can shop for bras and begin to wear your preferred clothing styles at this point. You should wear the post-surgical bra supplied by our office for at least the first two weeks.
Q: Will insurance cover my Mastopexy procedure?
A: No. Mastopexy is generally considered a cosmetic procedure, and therefore insurance will not pay for any portion of the procedure.