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What is a Breast lift / mastopexy?
I am glad you asked that question. A breast lift or “mastopexy” is an operation often used for patients who have lost a great deal of the laxity in their breast tissue. As a consequence, they note that their breast “sag.” In some cases, their breasts seem to have simply hollowed out. Most women are unhappy with the shape of their breasts and therefore wish to be considered for a procedure that will effectively lift their nipple/areolar complex and make their breast less loose and more “perky.”
What size can I be?
Size is a curious question. Most women have an idea of what size they wish to be. However, when a breast lift is considered they are less concerned about size as opposed to shape. They want a shapely breast back. Unfortunately, most women fail to realize the dynamics involved. Let me elaborate. When loose breast tissue is recontoured and a nipple/areola is lifted, the breast tissue is still loose, but the nipple and areolar complex is now more where it should be. The tissue lends itself very poorly to giving the patient the fullness they desire. For this reason, to get a proper response most often we consider patients for a combined procedure with a lift and an augmentation. The augmentation then allows us to maximize the fullness of the breast and allows the patient the best cosmetic result. When a combined procedure is considered, then size is an issue and a point of discussion.
What are the possible complications of breast lift / mastopexy?
Like any surgery, there are risks and complications. With breast lifts/mastopexy, the most common risks and complications are bleeding, infection, nipple skin sloughing, numbness, and contour irregularity. Bleeding can happen if the local epinephrine solution has not had time to work. Infection is always a concern with any surgical procedure in which the skin is violated. Preoperative antibiotics are given. This is further complemented with post-operative oral antibiotics. Nipple skin sloughing is a concern because some of the skin sometimes seems to slough. Most often the skin around a nipple is rather resilient and the sloughing is allowed to heal secondarily like a scrape. After several weeks, the area has very good remodeling and is not even noticed. Numbness is some cases is the most pressing concern. For obvious reasons, in females, any surgical procedure that may interfere with a sensation around a nipple needs to be approached carefully. Because the incision for the breast lift goes all the way around the nipple, there is a concern that there may be loss of skin sensation. This may be permanent or may last a short time. Most often the loss of sensation or the change in skin sensation is short-lived. But the patient should be made aware that permanent numbness is a real possibility. Last but not least, contour irregularity is a concern. When the nipple areolar complex is repositioned, it can scar unevenly. One side may have a slight tilt and the other side may not. Most often this contour irregularity corrects itself over the 3 to 6 months following surgery. In cases that this does not happen, the nipple/areolar abnormality can be corrected with local anesthetic in the office setting.
How painful is the procedure?
Like any surgical procedure, there is pain involved. Most patients comment that they have a mild to moderate amount of pain. Most of the pain seen with breast lifts / mastopexy is due to the bruising and the swelling involved. In fact most complain more about the soreness and aching sensation than actual pain. To help with the pain, we regularly give patients oral and intravenous pain medicines in the
post-operative period. Upon their discharge from the hospital, we supplement this with oral pain medication. It must be noted here that at the time of the surgery, the incisions are infiltrated with local anesthetic medication that lasts six hours, in an effort to help with
How long do I have to take off from work?
Great question. Most often I suggest to patients that they consider taking about 1 to 2 weeks from work. Let me elaborate. Once the operation is completed, the area involved becomes swollen and in many cases becomes extremely bruised. This area then slowly goes through healing. I ask most of my patients to start walking by day#2. I ask them to stay away from exercise at the gym for about 4 weeks. I believe this prevents the development of excessive swelling. As for work though, most patients are fairly comfortable in returning by week 3. However, this does depend on what type of work the patient does.
Can I combine this procedure with any other procedure?
Yes and no. Like any surgical procedure, there are limits to what can be done and what is safe. As for the yes, it can be combined with some other procedures. For example, I routinely do this procedure with a breast augmentation. I feel that this allows the breast contour to be maximized. Let me explain. Once a nipple has been lifted, it tends to sit on a hollowed area, even though it is more in the right position. Patients often complain of having poor upper pole fullness. By using an implant, the breast tissue pocket is maximized, the breast is fuller and perkier and then the new nipple positioning is ideal.
Besides an augmentation, other procedures are routinely done
along with breast lifts. Any procedure that may be too long
or too arduous and place the patient at risk for significant
bleeding or significant anesthetic exposure would have to
be deferred and done in two stages. Please understand I say
this without knowing exactly what you, the patient, may have
in mind. I can only speak from my experience.
Am I a good candidate?
Plastic surgery is not for everyone. It involves certain risks like any operative procedure. As long as you are aware of this fact, you can be considered for the procedure. However, in every case, the patient is best served by a thorough evaluation of their history, their body and
their overall expectations. You as the patient have to be realistic and cognizant of what is possible and what is reasonable. Trust me I am from Beverly Hills and I have had the privilege of working with many of the famous groups of plastic surgeons in LA. I can simply tell you there is no magic. We offer an opportunity to help you with surgical procedures in correcting what you may think is abnormal about your body. Also please understand that for many patients no surgery is needed; just a friendly word of encouragement and confidence from the local plastic surgeon.