The shape and form of the female breast is representative of a woman’s intrinsic beauty. Breasts are formed by the developed mammary gland tissue, fat and interspersed ligaments and its development is completed between 16 and 18 years of age. Sagging of breasts occurs partly due to the effects of gravity and partly due to deterioration of glandular tissues and stretching of ligaments connecting the skin to the underlying muscles. Apart from age, multiple pregnancies, breast feeding, rapid weight gain and loss, and genetics play a role in this sagging process. Breasts that have lost their firm, uplifted contours can affect a woman’s self-image and confidence.
Breast lift surgically relocates the breasts to a higher location on the chest wall, removes excess loose skin and thus tightens and reshapes the breast to make it firm and youthful looking. A Breast lift can also reduce the size of the areola (pigmented skin surrounding the nipple). A breast lift rejuvenates the female figure with a breast profile that is youthful, uplifted and firm.
Who is an Ideal candidate?
You can benefit from a breast lift if
Your breasts have lost volume and firmness
You have breasts that are pendulous with a flatter, elongated shape
Your nipples point downward or fall below the breast crease when the breast is unsupported
You have stretched skin and/or enlarged areolas
You have breasts which are asymmetrical (one breast lower than the other)
For patient's with small, saggy breasts with lost volume, it is desirable to combine breast implants with the breast lift procedure.
Have a positive outlook and realistic expectations about outcome.
Although mastopexy can be performed at any age, it is usually recommended to wait until breast development is complete. Most surgeons will recommend waiting until a woman has completed her family, since pregnancy and breastfeeding may have significant and unpredictable effects on the size and shape of your breasts.
The Primary Consultation
During the consultation, you will be asked about your desired breast shape and size. This will help to understand your goals and expectations and determine if they can be achieved realistically. Any risks or complications involved will be explained. Details of the surgery regarding nipple and areola repositioning and desired volume will be discussed.
It is important for you to provide complete information about your past medical history, any medical illness, drug allergies, previous surgeries including breast biopsies, and medications that you currently take. It is recommended that you stabilize your weight prior to surgery. Individual factors and personal preferences will determine the specific technique selected to lift your breasts.
General Guidelines prior to surgery for Mastopexy
An initial Breast examination and detailed measurements will be taken
Pre operative photographs will be taken
Pre-operative Anaesthetic assessment for fitness for surgery
Agreement to proceed with the surgery by signing an informed Consent Form
Abstain from alcohol for 7 days prior to surgery
Stop smoking 2-3 weeks prior to surgery
Avoid taking anti inflammatory medicines e.g. Aspirin for 14 days prior to surgery
Stop taking the oral contraceptive pills 6 weeks prior to surgery and use alternative means of contraception
Grading of Breast Ptosis
1. Mild ptosis: the nipple-areola complex is slightly below or in the level of the inframammary fold.
2. Mild to moderate ptosis: the nipple-areola complex falls less than 3 cm below the inframammary fold.
3. Severe ptosis: the nipple-areola complex falls more than 3 cm below the inframammary fold.
The Operative Procedure
Your breast lift surgery should be performed in a major hospital under general anaesthesia for your comfort. The attending Anaesthetist will explain the type and risks of the particular form of anaesthesia for your operation. The procedure for a breast lift is similar to that for scars.
A common traditional 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. This gives an anchor shaped scar.
If done by the modern technique, then only a single vertical scar will be present. In some instances, it may be possible to avoid the horizontal incision as well as the vertical incision that runs from the bottom edge of the areola to the breast crease giving minimal scars. A tube to drain out collected blood may need to be placed, depending upon the amount of dissection. Mastopexy is usually combined with a breast implant in women with small volume saggy breasts.
Post Operative Care
You usually have to stay a minimum of one night in the hospital after your operation. If tube drains have been placed in your breasts they are generally removed 1-2 days later. It usually takes 2-3 days to recover from the surgery. All wounds are well healed within 7-10 days of the procedure. Stitches are usually absorbable and do not need to be removed.
There will be some bruising and swelling which usually lasts for approximately 2- 4 weeks. It is important to remember that the breasts may take approximately 3-6 months to achieve their final shape and feel.
Patients can get back to work within a week and to a normal exercise programme 4 weeks after the surgery. You will be instructed to wear a support bra for 6-8 weeks, until the swelling and discoloration of your breasts diminish.
Risks and Potential complications
Although rare, bleeding and infection are possible risks. You may notice less sensation in the nipple and areola areas. This is usually temporary. It may, however, take weeks or even months before sensation returns to normal. It is important to remember that the human body is asymmetrical and the breasts are no different. Therefore breast asymmetry may persist after the surgery. Specific potential complications relating to mastopexy are rarely loss of the nipple due to poor blood supply, incision site scarring and difficulty in breast feeding.
Approximately less than one per cent of all operations can 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.
Will there be a scar?
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 skin type and the Plastic Surgeon’s expertise. In most patients the scar heals well, but in a very small number of people the scar remains thick and heavy.
How long will the effect of a breast lift last?
Unless you gain or lose a significant amount of weight or have multiple pregnancies, your new breast shape should remain fairly constant. The operation does not prevent the influence of gravity and time and therefore the uplift effect may not be lifelong.