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Breast Lift (Mastopexy)
San Francisco - Oakland - Santa Rosa - Marin
Breast Lift (Mastopexy)
If you have lost volume in your breasts and the nipple has lost its position, you may be a candidate for a breast lift.
Breast lift or mastopexy is a surgical technique that elevates the nipple and reshapes the breast tissue. The technique is most commonly used for woman who have had children, lost weight, or have a genetic predisposition for breast ptosis (looseness).
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During pregnancy, the breast becomes engorged which expands and stretches the skin envelope. This is often accompanied by loss of breast volume and the breast will lose its shape.
The breast lift will reposition the nipple of areola complex and rebuild the remaining breast tissue. Often, if there isn’t enough breast tissue, a breast implant can be inserted.
Another popular breast lift is the peri-areolar mastopexy. This is a good technique for patients who require a small lift. The incision is made around the areola and a donut-shaped section of skin is excised. The skin is sutured with a "purse string" technique and the incision is hidden within the areola.
Breast lifts may be accompanied by other procedures such as facial surgery or body contouring.
Who is a candidate?
The best candidates for breast lift surgery are healthy, emotionally stable women who have realistic expectations. Any woman who has experienced a downward migration of the nipple, accompanied with a loose skin envelope is a candidate for a breast lift. Occasionally, a woman may have a genetic predisposition for breast ptosis. It is advisable that women wait until they have had children before considering a breast lift.
Prior to surgery
A personal consultation is the first step for every patient considering a breast lift. During this appointment, Dr. Delgado will ask you to discuss your concerns about your appearance. He will use digital photography and computer imaging to discuss any asymmetries you may have to display the location of the incisions. He will also discuss where the nipple should be positioned. In addition, he will discuss the variables that effect your individual procedure; such as age, size the shape of your breasts, the condition of your skin, and the possibility of a breast implant.
Depending on your age and family history, Dr. Delgado may advise a mammogram before surgery.
Dr. Delgado provides a precise preoperative booklet that provides pre and postoperative instructions, including medications in advance of your surgery. All aspirin and aspirin containing products, including anti-inflammatory products must be stopped two weeks before and two weeks after surgery. Dr. Delgado’s preoperative instructions will have a complete list of these medications to avoid. Tylenol may be taken during this time. Also you will be given a list of homeopathic preparation as well as vitamins to take prior to and after surgery. This is done to promote healing and limit bruising.
Anesthesia
Most breast lift surgeries are performed under general anesthesia. They are typically performed in an out patient surgery center or hospital.
Operative Procedure
Before anesthesia is given, a surgical marking pen is used to draw a detailed “map” on the breast and chest. This architectural plan enables the doctor to make the accurate changes from the sitting to the lying position.
After anesthesia is given, incisions are made around the areola and downward to the crease underneath the breast. This modern breast lift incision is shaped like a “lollipop”. The older technique is the inverted T-incision which produces much larger scars. The other advantage of the lollipop incision, is that the breast tissue is reconstructed in a conical shape which has a long lasting effect. The inverted T-incision holds the breast shape by changing the skin envelope only. The skin stretches out in time and the breast shape is lost.
The breast skin is closed with multiple layers of fine sutures. A drain may be place to absorb any extra body fluid.
Regardless of the incision, the nipple areola complex will be moved upward and the skin tightened. A breast implant can be added to increase volume.
After Surgery
The first few hours after surgery will be spent in the recovery room. When you are fully alert, you will be able to go home with the assistance of a friend or a family member. At this time it is important to sleep with the head and back elevated to reduce the swelling in the area. If a drain is placed it will be removed in two days. A compression dressing is maintained and stays in place for approximately one week. At that time, the dressing is removed and the bra is replaced. Your breasts will be bruised, swollen, and uncomfortable for a day or two, but the pain is not severe. This discomfort is more noticeable if the patient has had breast implants placed underneath the muscle. These patients will notice more tenderness and soreness around the chest region.
Patients take medications during the first day or two in order to be comfortable during the recovery. By the third day the patient shouldn’t need strong pain medications. However, some patients have a lower pain threshold and therefore may take pain medications for up to five days.
The recovery period is generally two weeks. Once the bruising and tenderness is gone, the patient can return to normal activities. It is then an absolute priority that the patient avoids lifting of any kind for at least two weeks post operatively. Most patients may drive a car and return to work or social activities after a week. Strenuous exercise is avoided for three to four weeks following surgery.
You should avoid sex for the first week or so after surgery since this can increase swelling and discomfort.
Risks and Complications
A breast lift is not a simple procedure, but is usually safe when performed by a qualified plastic surgeon. Like all surgeries, it carries the risk of bleeding, infection, and the risk of anesthesia.
Breast lifts leave permanent scars, although your bra or bathing suit will cover them. Breast sensation may be altered temporarily, but rarely permanently.
Outcome
The goal of the breast lift is to elevate the nipple areola complex and to reshape the breasts. This surgery accomplishes a new balance of the breasts with the body and can enhance shape and possibly size if a breast implant is added.
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