Breast Lift (Mastopexy)

Breast Lift (Mastopexy)

Most women will notice their breasts start to sag as a result of the ageing process.  This problem can be exaggerated when the breasts become distended during pregnancy and breast feeding and subsequently lose volume. Weight fluctuation can also contribute to the breast skin becoming stretched and then drooping.  The force of gravity also takes it toll. All this contributes to the breasts eventually losing their youthful shape.

Treatment

It is possible to reshape the breasts by removing surplus skin, giving a more youthful shape and firmer feel.  The nipples will be repositioned to a higher level during the procedure to correspond with the shape of the remodelled breasts.  If the breasts are small as well as droopy, breast implants can be inserted at the same time as performing the uplift.

Limitations

The procedure does not restore the natural supporting structure of the fibrous bands of the breasts. The uplifting effect is achieved through the removal of excess skin from the breast and sometimes remodelling the breast tissue, giving a tighter cone when remodelled.

It is difficult to predict how long the effect will last. The ageing process and gravity will continue to exert their effects on the skin and women will notice a return of a degree of droopiness over time. This droopiness may not be as exaggerated as the initial problem.

 It is advisable to wait until no further pregnancies are planned before having the procedure as pregnancy will contribute to further drooping of the breasts.

The procedure gives better results in smaller breasts. 

Larger breasts can be lifted, but the result may not last as long. Wearing a bra to support the breasts as much as possible can lessen this problem.

The Procedure

There are different techniques, but the illustration shows the most common position for the incisions. The excess skin is removed and the point of the incisions are sutured together into an uplifted, firmer feeling breast.  The sutures are usually absorbable. A wound drain is usually inserted into each breast during surgery to drain away any excess blood and fluid. Once the drainage settles, the surgeon will ask the nurses to remove the drains (usually about 24 hours after surgery).

Post Surgical Care

Steri-strips, dressings and adhesive strapping are applied to the breasts immediately following surgery.  Usually, your bra will also be put on you in theatre before  you wake up.  It is likely that you will have a wound drain in each breast to prevent blood or fluid accumulating. These will be removed once the drainage has decreased—approximately within 24 hours. You will experience some discomfort in the early days, but you will be prescribed pain-killers to control this.

What to expect following surgery

The sutures will usually be absorbable but if there are any that need removing, this will be done at your first outpatient follow-up appointment, 10-14 days after surgery.

Most surgeons will leave the strapping in place until the first follow up visit and you will be expected to wear your bra continuously during this time to give adequate support. Some surgeons may advise continuous wearing of a bra for longer than this. It is probably better to continue wearing a sports-type bra for about six weeks. Underwired bras can put too much pressure on the healing incisions.

Bathing will be advised for the first 1-2 weeks to avoid getting the dressings wet. Once all the strapping is removed, you will be allowed to shower.

Avoid strenuous exercise such as lifting and sports for 4-6 weeks. You will be able to return to work after 2-3 weeks, depending on how physical your job is. It is also advisable to avoid driving during this time.

The scars will gradually fade over the next 6-12 months. Initially they may appear red and lumpy, but will become paler with time. The scars will be permanent but should not be visible under normal underwear or swimwear.

The initial shape of your breasts following surgery can sometimes appear a little ‘box-like’. This will soften to a more natural shape over the coming weeks as the tissues and swelling settle down.

Risks

 All surgery carries an element of risk. This includes bleeding, pain, infection, thrombosis and, of course, scarring. The risk of bleeding can be minimised by avoiding the use of aspirin and other anti-inflammatory drugs for a week before surgery.  At Sancta Maria Hospital patients planning on having breast surgery will have swabs taken prior to admission to check for MRSA.  If an infection does occur antibiotics will be prescribed and extra dressing changes may be necessary. Scarring is an inevitable, permanent outcome of surgery.

There is a risk of thrombosis after surgery because a patient will not be as mobile as usual. The risk is reduced by giving patients anti-embolic stockings to wear and administering a low dose of heparin by injection once a day while in hospital.  All patients are also encouraged to be up and about as soon as possible after surgery, to further reduce the risk of thrombosis.

Other risks associated with breast surgery can include numbness of part of the breast or nipple, which is sometimes permanent. Smoking and being overweight increases the likelihood of post-surgical complications.

The information contained in this website is not exhaustive. A full consultation with a suitably qualified surgeon will enable you to have your individual requirements and risk factors assessed and to ensure that this type of surgery is suitable for you.

Sources/Further Information:

· British Association of Aesthetic Plastic  Surgeons (BAAPS)

· Department of Health Cosmetic Surgery: Information for Patients (August 2006)

· NICE Venous Thromboembolism (April 2007)

· NICE Surgical Site Infection Prevention & Treatment of Surgical Site Infection (October 2008)