BREAST LIFT

A Breast Lift is a procedure designed to restore a more youthful appearance to sagging breasts. As we age breast tissue loses some of its elasticity and fat, causing the breast to droop.
Some important facts about mastopexy:

• Women who go braless tend to have droopier breasts; gravity plays a part in causing breasts to sag.
• A breast lift changes the shape of the breast, not the volume.
• This procedure can be performed in conjunction with a breast augmentation if you feel you do not have adequate breast tissue.
• Many doctors may choose not to perform a breast lift on smokers as smoking diminishes blood flow and may result in the breast skin and nipples not surviving the surgery.

ALTERNATIVES TO SURGERY
Unfortunately, there are no alternatives to surgery that can bring a bustline back up to a more youthful position. Mechanical alternatives such as underwire bras or breast pad inserts only give the appearance of lifted breasts.

PREPARING FOR SURGERY
Depending on the size and laxity of your breasts, your physician may recommend a breast reduction and/or implants in conjunction with a breast lift. Be absolutely clear with your physician about the look and size you want for your breasts, as well as the location of the scars.

Prior to surgery, you should be instructed to have certain lab tests (ie. blood work, chest x-ray or an EKG completed). You will also be instructed to have a mammogram if you have not had one recently. You will be given certain guidelines on eating and drinking, smoking, and taking vitamins and medications.

THE PROCEDURE
The technique used will depend on the amount of ptosis (drooping) of the breast and your physician’s training and experience. The location of the incisions is dictated by the technique utilized. The following techniques are most often used for breast lifts:

• Crescent - for mild ptosis. This is an upper-areolar incision only.
• Circumareolar - for mild ptosis. One continuous incision around the areola can be used.
• Vertical - for moderate ptosis. The same continuous incision around the areola is used, along with a vertical incision down the lower half of the breast to the chest wall.
• Anchor or inverted T (the most common technique used) - for severe ptosis. The same continuous incision around the areola with the vertical incision is used, along with a five-to-seven-inch incision made in the crease underneath the breast.

Most surgeons do not completely detach the nipple. It is freed via the circumareolar incision, but attachment to the tissue, which includes milk ducts, blood supply, and nerve endings is maintained. However, nipple sensation and the ability to breast-feed may still be lost.

In this type of surgery, excess skin is cut away so that the remaining skin is tightened. Some women choose to have breast implants in conjunction with a breast lift. The areola is then repositioned, and the tissue underneath the skin is sutured with dissolvable stitches, and drains may be placed. The skin is then sutured close.

Anesthesia
A breast lift is usually performed under general anesthesia, but some doctors perform it under intravenous sedation with local anesthesia.

Length of Procedure
A breast lift takes approximately two to four hours.

Level of Pain/Discomfort
Generally with a breast lift there is moderate pain during the postoperative period, which may be controlled with prescribed pain medications or Extra-Strength Tylenol.

PRE- AND POSTOPERATIVE INSTRUCTIONS
The following suggestions are intended to make you feel more comfortable and help you heal:

• If you have regular mammograms or are over the age of 40, schedule a mammogram prior to your procedure and then again after the swelling and tenderness have disappeared completely (three to six months). This way, the changes resulting from your surgery can be documented.
• Stop smoking, discontinue the use of alcohol, and stop taking vitamin E and any medications containing aspirin or ibuprofen (two weeks pre- and postoperative is usually recommended). Check with your doctor regarding any other medications (including homeopathic/herbal products) that you are currently taking.
• Do not have food (including gum or mints) or drink (including water) for a minimum of six to eight hours prior to surgery. (Follow your surgical facility’s preoperative instructions.)
• Have someone stay with you the first night after surgery (the first twenty-four to forty-eight hours, optimally).
• Do not lift anything heavier than a small telephone book for at least ten days.
• Dressings – this procedure may require a supportive bra or dressing, which should be provided, to wear four to six weeks after surgery. You may want to purchase a second garment to wear while you launder the other. Do not wear an underwire bra for six weeks, especially if the incisions are in the crease underneath the breast.
• Drains – if they are placed, will be removed in two to three days.
• Your doctor may instruct you to apply cold compresses, usually for twenty minutes every hour for a minimum of forty-eight hours. Do not apply cold compresses to the nipple area.
• You must sleep on your back with your upper body elevated for at least the first week to ten days.
• Do not lie face down for at least three weeks.

RECOVERY
The initial healing period for a breast lift can take, on average, from one to two weeks, however everyone heals differently. Healing is affected by many factors, including your genetics, whether you smoke and/or drink alcohol, pain tolerance, and the extent of the surgery.

The first day after surgery, you will probably experience soreness and tenderness and will probably want to sleep. You can expect some swelling and bruising, which usually heals in two to three weeks. Minor swelling can last as long as six to nine weeks. Bruising can last up to six weeks. You may also experience some temporary numbness, and itching around the incision sites. If the incision sites itch, do not scratch them, instead gently rub them with ointment prescribed by your doctor.

RISKS / COMPLICATIONS
Any type of surgery carries a certain amount of risk. However, if you have selected your surgeon carefully, researched your options, and comply with pre-and postoperative instruction, your risk of complications is minimal.
Complications that can occur include hematoma (a collection of blood under the skin), changes in nipple sensation (may not be permanent), infection, and asymmetry, which may require another surgery. Over time any scarring should fade and become barely noticeable.

STILL YOU…ONLY BETTER
The results of a breast lift can be very gratifying. When done in conjunction with a breast augmentation, the fuller firmer bustline can be very appealing, and can make clothes fit in a more flattering manner. Over time, gravity will still take its toll, but the effect will be less that if you never had the breast lift at all.