Due to many factors – such as age, hormones, pregnancy, weight fluctuations, genetic, ethnic, breast implants – a woman’s breasts can begin to sag and droop. With breast lift surgery (or mastopexy), expert plastic surgeons can help restore them to a firmer, shapelier state. If you are a woman who is interested in undergoing this surgery, there are some important things you need to know about the procedure.
What Do Breast Lift and Breast Augmentation Lift Surgeries Do?
It is natural for a woman’s breasts to change over time, often losing their firmness and shape. This is called breast ptosis. This can be caused by a number of factors, including:
- Weight gain
- Weight loss
- Hormone fluctuations
- Breast implants
A breast lift surgery raises and reshapes the breasts by excising excess breast glandular tissue and skin, mostly along the lower pole, and tightening the breast. In many cases, if there is loss of breast volume or no upper pole fullness, breast implants can be inserted during the lift to achieve better shape and bigger size. The nipples and areolas are raised into a more forward position, while large and stretched areolas are reduced. The result is firmer breasts that look natural and a figure that is better proportioned. You are able to get a breast lift at any age after your breasts have finished developing.
Am I A Candidate for Breast Lift or Breast Augmentation Lift?
You qualify as a candidate for breast lift surgery if:
- You breasts are sagging, having lost their volume, shape, and firmness
- One of your breasts is lower than the other
- Your areolas are enlarged and stretched
- Your nipples and areolas point downward
- Your breasts are unusually shaped or asymmetrical
- You are maintaining a stable weight
- You are physically healthy
- Your expectations are realistic
Before undergoing the operation, choose a skilled and experienced surgeon you trust, who is able to perform the surgery in a modern facility that is equipped with advanced medical equipment. It is very important that you discuss every aspect of the procedure and what you can expect with your surgeon beforehand. You might also be required to send pictures of your breasts so that the surgeon can assess your condition prior to your first meeting. Make sure you listen carefully to your surgeon’s opinion and voice any concerns or questions you might have.
Prior to the surgery itself, you must:
- Inform your surgeon of all your medical conditions and allergies.
- Inform your surgeon of the medication that you are taking
- Inform your surgeon if you are suffering from hypertension
- Avoid aspirin and any medication containing aspirin or derivatives of aspirin such as NSAIDs or anticoagulants for 2 weeks or as advised
- Refrain from smoking for 2 weeks, as nicotine can affect your response to the anaesthetic and complicate your healing process
Pre-operative Surgical Planning
To achieve a good outcome, your surgeon will analyse your breast footprint thoroughly for the quality of skin, marking several reference points to measure the width and height of your breasts, distance from nipple to breast fold, diameter of areola, and approximal volume of each breast. Then your surgeon will draw another set of markings to locate the new nipple areolar site (which is mostly higher) and all other tentative surgical incisions. You will be able to try to fit several implant samples if you are looking for bigger breasts after the lift. Your surgeon will discuss with you until you are both in consensus regarding the anticipated result. If there is any difference of breast footprint parameters, your surgeon will be aware of the amount of tissue, the size and shape of implants to be used on each breast for more even breasts after the operation.
Breast Lift or Breast Augmentation Lift Surgery
You will be put under general anaesthesia, with the operation lasting 4-6 hours. During the surgery, the surgeon will start first by assessing how much the breast needs to be lifted. A nipple areola is cut and raised to the new position according to the pre-operative incision marking, then followed by cutting along the pre-operative marking along the lower pole of the breasts and excising excess breast glandular tissue and skin. Then the doctor will tighten the remaining breast glandular tissue and skin to achieve the desired result. In many cases (but not all), the surgeon will create a proper pocket space either over/under the chest muscle or dual plane before the implants are inserted. There are a variety of incision techniques a surgeon can use, such as circular incision around the areola, lollipop incision (circumareolar with additional vertical limb from areola to the breast fold) or upside-down T (circumareolar plus vertical limb and under breast). The surgeon will determine which technique is most appropriate for you based on the sizes and shapes of your breasts, the degree of sagging, your skin, and the position and size of your areola.
Sutures are inserted into the tissue to support the newly shaped breasts, while enlarged areolas are reduced by removing the skin around their perimeters. The remaining skin around the breasts will be tightened when the incisions are closed. Two small tubes might be placed in each breast to drain fluids and blood. These incision lines are permanent, but they will fade over time.
You will be wrapped in bandages and gauze dressings after surgery. These bandages will be removed the next day or a couple of days after the operation and the drainage tubes will be removed. All the incisions will be covered with water-proof bandages, so you are able to take a shower. The area must be kept dry, especially after showering. If there are no complications, you will only need to stay 1-2 nights in the hospital and follow up with your surgeon 1-2 times before returning or flying back to your home country.
If the surgeon did not use dissolvable sutures during the operation, your sutures will be removed within 7-10 days. For dry skin a moisturizer, especially Vitamin E cream, is recommended. Applying cold packs can also help reduce the swelling and bruising. You can apply scar-minimizing cream along the incisions after the wounds heal completely, which is usually 2-3 weeks after surgery. There are many brands on the market, so ask for a recommendation. It can help lessen the scarring.
You will be required to wear a surgical bra. This bra must be worn at all times until the swelling subsides. Usually, the surgeon will advise you to wear it for several weeks, only taking it off to wash it or to take a shower. You can switch to normal bras 1-2 months after surgery. It is recommended that you lay on your back to sleep, or possibly on the side from time to time, but do not sleep on your stomach for at least 1 month.
In most cases, recovery takes two weeks, with most patients returning to work in three weeks. For the first 1-2 months you must not place tension on the wound by performing strenuous activities. However, 2-3 weeks after surgery, you are allowed to lift your arms above your head, carry light objects and drive. You are allowed to start exercising lightly 1-2 months after surgery, but it will take much longer before you can resume sports or hard exercise. While you will be able to breastfeed afterward, a pregnancy can impact the improvements made by the breast lift, as can extreme fluctuations of weight. After a lift, your breasts are still at risk of sagging and drooping if the enveloping skin slowly loses its strength to hold the remaining breast tissue or implants. Maintaining a healthy weight and lifestyle are also essential to your recovery.
Risks and Complications
There are risks to any surgery. For breast lifts and breast augmentation lifts, the risks include bruising and swelling, numbness or hypersensitivity of nipple areola, scarring of surgical incisions, etc. These risks are only minimal, and rarely occur.
There are a few complications which will need close attention or urgent surgical intervention to prevent further damage to the outcome, such as seroma (collection of serum fluid around the breast implants), hematoma (large amount of blood clot collection around the breast implants), nipple areolar blood supply impairment, surgical stitches infection, etc. Some complications, although not frequent, may happen weeks later and may need surgical correction later, such as nipple areolar necrosis, late surgical wound infection (causing implant extrusion) or capsular contracture.
Breast Lift and Breast Augmentation or Reduction
A breast lift surgery does not change the size of your breasts. Therefore, some women may want to consider breast augmentation or breast reduction in combination with a breast lift. A skilled and experienced surgeon can perform both these operations in a single procedure. In the case of breast augmentation, the implants will be placed under the breast tissue during your breast lift.
- American Board of Cosmetic Surgery: Breast Lift Guide. Available from: http://www.americanboardcosmeticsurgery.org/procedure-learning-center/breast/breast-lift-guid. Accessed on September 6, 2017.
- American Society of Plastic Surgeons: Breast Lift. Available from: https://www.plasticsurgery.org/cosmetic-procedures/breast-lift/safety. Accessed on September 6, 2017.