Factors often impacting on the shape of the breast and the nipple are pregnancy, nursing, weight loss and gains and forces of gravity. These stresses usually cause an elongated shape to the breast and a lower and widening of the nipple areolar complex. Correction of this shape and reduction of the diameter of the nipple areolar complex often requires a breast lift. (The areola is the darker skin surrounding the nipple.)
Breast implants can inserted in conjunction with mastopexy to improve the size, shape projection and upper pole fullness of the breast.
Candidates of breast lift
The best candidates for a breast lift are healthy, emotionally stable women who are realistic about what the surgery can accomplish. Also it is preferable that a woman has had all the children she plans to have and have a stable body weight. The best results are accomplished in women with small to medium size, sagging breasts, but with proper support the shape of even larger breast can maintain with acceptable appearance. Many times a woman will elect to have an implant placed under the breast to augment the shape of the breast. Natural breast many times are unable to hold the projected and rounded shape over a period of time, especially in the upper breast regions. This is due to the fatty nature of the breast. Many times the fatty nature of the breast doubles after pregnancy.
What should I expect from the consultation?
The consultation is the first step before considering breast lift. Your personalized one-on-one meeting with Dr. Bridges will assess your physical and emotional health. This is followed by a discussion of your specific goals for the surgery.
You should arrive at the consultation prepared to provide complete information about:
- Previous surgical procedures
- Mammogram history
- Past and present medical conditions
- Family history of medical conditions, particularly about breast cancer and prostate cancer
- Medications you are taking, including herbal remedies or nutritional supplements.
When examining your breast, Dr. Bridges will evaluate:
- The quality of your breast tissue.
- The location of any existing scars.
- The degree of skin laxity and stretch marks.
- The size of your breasts and differences between the two breasts.
- The nipple size and location and the differences between the two.
Photographs may be taken for your medical file. Dr. Bridges may have other suggestions for procedures to improve your results. For example, if your breasts lack volume and projection he may recommend a small breast implant to improve the results. Dr. Bridges will describe in detail the procedure, risks and limitations, scaring that will result, anesthesia used and the type of facility where the surgery will be performed.
Understand you will probably not get a result that you see in a magazine or like you friends. Everyone is different and "what you bring to the table will be different than what someone else brings to the table."
What are complications related to breast lift?
As with any surgery there is always a possibility of complications or a reaction to the anesthesia. Bleeding and Despite the nature of breast tissue infections following a breast lift are very uncommon. Mastopexy does leave noticeable, permanent scars, although they’ll be covered by a bra or bathing suit. (Poor healing and wider scars are more common in smokers, so it is recommended that one stops smoking 4 weeks prior to the operation.) There is a possibility of unevenly positioned nipples due to postoperative swelling which can stretch the skin, also there is a small possibility of permanent loss of feeling in your nipples or breast. These differences are not predictable.
Planning your surgery
You may be required to have a mammogram before surgery due to your age and family history. Specific instructions will be given to prepare you for surgery. These will concern eating and drinking the night before surgery and the avoidance of smoking and certain vitamins and medications. A breast lift is an outpatient surgery. Also be sure to arrange to have someone drive you home after the surgery.
The operation
Anesthesia is usually local with sedation. You will be asleep throughout the surgery.
Mastopexy takes approximately two to three hours depending on the severity of breast distortion. The procedure usually involves an anchor-shaped incision following the natural contour of the breast. Small incisions will be determined at the time of surgery depending on the degree of skin elasticity.
Dr. Bridges will mark your breasts just prior to the surgery with you in a sitting or standing positions. These markings will outline the area of breast skin to be removed and define 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 brought together to reshape the breast. Stitches are usually located beneath the skin around the areola, in a vertical line extending downwards from the nipple area, and along the lower crease of the breast.Patients especially those with relatively small breasts and minimal sagging may be candidates for a modified procedure 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 are 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 the surgery
Your breasts will be bruised, swollen, and uncomfortable for a day or two, but the pain shouldn’t be severe. You’ll wear an elastic bandage or a surgical bra over gauze dressings. Any discomfort should be relieved with medication prescribed by Dr. Bridges and an cool compress lying over the breast.
Within a few days, the bandages or surgical bra will be replace by a soft support bra. You’ll need to wear this bra around the clock for three to four weeks, over a layer of steristrips. The stitches will be removed after a week or two.
Getting back to normal
Healing is a gradual process. If your breast skin is very dry, apply a moisturizer several times a day except to the suture areas. Loss of feeling in your nipples and breast skin is commonly caused, by 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.
You may be up and about in a day or two, but you might have to wait a week or more to return to work depending on how you feel. Avoid lifting anything over your head for three to four weeks. If you have any unusual symptoms, don’t hesitate to call the office.
If you become pregnant, it is unlikely the operation will affect your ability to breast-feed since your milk ducts and nipple will be left intact.
It is important to remember that mastopexy scars are permanent. In a few patients they may remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Also keep in mind that a breast lift won’t keep you firm forever - the effects of gravity, ratio of fatty tissue to breast tissue, pregnancy, aging and weight fluctuations will eventually take their toll again. Usually pregnancy and excessive weight gain have the biggest impact on the shape of the breast. Your satisfaction with a breast lift is likely to be greater if you understand the procedure and if your expectations are realistic.