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If you're considering a breast lift...
Over the years, factors such as pregnancy, nursing, and the
force of gravity take their toll on a woman's breasts. As
the skin loses its elasticity, the breasts often lose their
shape and firmness and begin to sag. Breastlift, or mastopexy,
is a surgical procedure to raise and reshape sagging breasts--at
least, for a time. (No surgery can permanently delay the effects
of gravity.) Mastopexy can also reduce the size of the areola,
the darker skin surrounding the nipple. If your breasts are
small or have lost volume--for example, after pregnancy--breast
implants inserted in conjunction with mastopexy can increase
both their firmness and their size. If you're considering
a breast lift, this brochure will give you a basic understanding
of the procedure--when it can help, how it's performed, and
what results you can expect. It can't answer all of your questions,
since a lot depends on your individual circumstances. Please
be sure to ask your doctor if there is anything about the
procedure you don't understand.
THE BEST CANDIDATES FOR BREAST LIFT
A breast lift can enhance your appearance and your self-confidence,
but it won't necessarily change your looks to match your ideal,
or cause other people to treat you differently. Before you
decide to have surgery, think carefully about your expectations
and discuss them with your surgeon.
The best candidates for mastopexy are healthy,
emotionally-stable women who are realistic about what the
surgery can accomplish. The best results are usually achieved
in women with small, sagging breasts. Breasts of any size
can be lifted, but the results may not last as long in heavy
breasts.
Many women seek mastopexy because pregnancy
and nursing have left them with stretched skin and less volume
in their breasts. However, if you're planning to have more
children, it may be a good idea to postpone your breast lift.
While there are no special risks that affect future pregnancies
(for example, mastopexy usually doesn't interfere with breast-feeding),
pregnancy is likely to stretch your breasts again and offset
the results of the procedure.
ALL SURGERY CARRIES SOME UNCERTAINTY
AND RISK
A breast lift is not a simple operation, but it's normally
safe when performed by a qualified plastic surgeon. Nevertheless,
as with any surgery, there is always a possibility of complications
or a reaction to the anesthesia. Bleeding and infection following
a breast lift are uncommon, but they can cause scars to widen.
You can reduce your risks by closely following your physician's
advice both before and after surgery.
Mastopexy does leave noticeable, permanent
scars, although they'll be covered by your bra or bathing
suit. (Poor healing and wider scars are more common in smokers.)
The procedure can also leave you with unevenly positioned
nipples, or a permanent loss of feeling in your nipples or
breasts.
PLANNING YOUR SURGERY
In your initial consultation, it's important to discuss your
expectations frankly with your surgeon, and to listen to his
or her opinion. Every patient--and every physician, as well--has
a different view of what is a desirable size and shape for
breasts.
The surgeon will examine your breasts and measure
them while you're sitting or standing. He or she will discuss
the variables that may affect the procedure--such as your
age, the size and shape of your breasts, and the condition
of your skin--and whether an implant is advisable. You should
also discuss where the nipple and areola will be positioned;
they'll be moved higher during the procedure, and should be
approximately even with the crease beneath your breast.
Your surgeon should describe the procedure
in detail, explaining its risks and limitations and making
sure you understand the scarring that will result. He or she
should also explain the anesthesia to be used, the type of
facility where the surgery will be performed, and the costs
involved.
Don't hesitate to ask your doctor any questions
you may have, especially those regarding your expectations
and concerns about the results.
PREPARING FOR YOUR SURGERY
Depending on your age and family history, your surgeon may
require you to have a mammogram (breast x-ray) before surgery.
You'll also get specific instructions on how to prepare for
surgery, including guidelines on eating and drinking, smoking,
and taking or avoiding certain vitamins and medications.
While you're making preparations, be sure to
arrange for someone to drive you home after your surgery and
to help you out for a few days if needed.
WHERE YOUR SURGERY WILL BE PERFORMED
Your breast lift may be performed in a hospital, an outpatient
surgery center, or a surgeon's office-based facility. It's
usually done on an outpatient basis, for cost containment
and convenience. If you're admitted to the hospital as an
inpatient, you can expect to stay one or two days.
TYPES OF ANESTHESIA
Breast lifts are usually performed under general anesthesia,
which means you'll sleep through the operation. In selected
patients--particularly when a smaller incision is being made--the
surgeon may use local anesthesia, combined with a sedative
to make you drowsy. You'll be awake but relaxed, and will
feel minimal discomfort.
THE SURGERY
Mastopexy usually takes one and a half to three and a half
hours. Techniques vary, but the most common procedure involves
an anchor-shaped incision following the natural contour of
the breast.
The incision outlines the area from which breast
skin will be removed and defines the new location for the
nipple. When the excess skin has been removed, the nipple
and areola are moved to the higher position. The skin surrounding
the areola is then brought down and together to reshape the
breast. Stitches are usually located around the areola, in
a vertical line extending downwards from the nipple area,
and along the lower crease of the breast.
Some patients, especially those with relatively
small breasts and minimal sagging, may be candidates for modified
procedures requiring less extensive incisions. One such procedure
is the "doughnut (or concentric) mastopexy," in
which circular incisions are made around the areola, and a
doughnut-shaped area of skin is removed.
If you're having an implant inserted along
with your breast lift, it will be placed in a pocket directly
under the breast tissue, or deeper, under the muscle of the
chest wall.
AFTER YOUR SURGERY
After surgery, you'll wear an elastic bandage or a surgical
bra over gauze dressings. Your breasts will be bruised, swollen,
and uncomfortable for a day or two, but the pain shouldn't
be severe. Any discomfort you do feel can be relieved with
medications prescribed by your surgeon.
Within a few days, the bandages or surgical
bra will be replaced by a soft support bra. You'll need to
wear this bra around the clock for three to four weeks, over
a layer of gauze. The stitches will be removed after a week
or two.
If your breast skin is very dry following surgery,
you can apply a moisturizer several times a day. Be careful
not to tug at your skin in the process, and keep the moisturizer
away from the suture areas.
You can expect some loss of feeling in your
nipples and breast skin, caused by the swelling after surgery.
This numbness usually fades as the swelling subsides over
the next six weeks or so. In some patients, however, it may
last a year or more, and occasionally it may be permanent.
GETTING BACK TO NORMAL
Healing is a gradual process. Although you may be up and about
in a day or two, don't plan on returning to work for a week
or more, depending on how you feel. And avoid lifting anything
over your head for three to four weeks. If you have any unusual
symptoms, don't hesitate to call your surgeon.
Your surgeon will give you detailed instructions
for resuming your normal activities. You may be instructed
to avoid sex for a week or more, and to avoid strenuous sports
for about a month. After that, you can resume these activities
slowly. If you become pregnant, the operation should not affect
your ability to breast-feed, since your milk ducts and nipples
will be left intact.
YOUR NEW LOOK
Your surgeon will make every effort to make your scars as
inconspicuous as possible. Still, it's important to remember
that mastopexy scars are extensive and permanent. They often
remain lumpy and red for months, then gradually become less
obvious, sometimes eventually fading to thin white lines.
Fortunately, the scars can usually be placed so that you can
wear even low-cut tops.
You should also keep in mind that a breast
lift won't keep you firm forever--the effects of gravity,
pregnancy, aging, and weight fluctuations will eventually
take their toll again. Women who have implants along with
their breast lift may find the results last longer.
Your satisfaction with a breast lift is likely
to be greater if you understand the procedure thoroughly and
if your expectations are realistic.
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Information provided by American
Society of Plastic Surgeons. |
