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BREAST LIFT



Also known as mastopexy, breast lift operations are aimed at women who are satisfied with the size of their breasts, but are annoyed by the sagging they display. Of course, the larger the breast, the larger the chance is that it will undergo sagging. Therefore, larger breasts are almost certain to undergo a loss in elevation after a certain amount of time, due to gravity.

The most often cause of fluctuations in size can be traced back to pregnancy or extensive weight loss. In such cases, the situation can be further worsened by stretch marks. This occurs because stretch marks are essentially scar tissue which reduces the skin’s elasticity.

This procedure aims to elevate the breast, and restore the nipple, which will have dropped to a lower position, back to its natural place.





This procedure has no relation to breast augmentation. These are two entirely different surgical operations and should not be confused. Of course, breast augmentation and lifting are procedures that can be combined. This applies to cases wherein the breast is not only sagging, but appears to have been “emptied” at the same time, shortly after a pregnancy.

Breast lifting is fairly similar to breast reduction. The only difference is that a breast lift does not require the removal of a gland, whereas breast reduction does.
 
THE CONCEPT OF THE OPERATION

The reason that the breasts have begun to sag is the loss of elasticity in the skin, which has created an excess of skin. This means that there is more skin in the breast area than there should be, as it has been distended. In addition, the nipple will have dropped to a lower position. A further problem is that sagging will have manifested in the various feature that compose the inner gland. Therefore, a breast must aim at correcting these features.

The aim of the operation is to:

•    Remove the excess skin via a number of incisions
•    Elevate the nipple to a higher position
•    Reshape the gland so that it can adhere to its new position.
Another basic aim is for the breast to acquire as conical a shape as possible.






BREAST LIFT TECHNIQUES

Over time, several different techniques have been developed for breast lift operations. When there is such a variety of techniques available for an operation, we can be certain that each of them has its advantages and disadvantages.

These techniques aim to give the breast as satisfactory a shape as possible while using as few incisions as possible. Usually, these numbers have an inverted correlation. This means that techniques that produce a better breast shape tend to require more incision.




Most patients are uncomfortable with the idea of incisions. However, it bears mentioning that in several cases the skin heals so well that these incisions will in time become almost invisible. However, as each patient heals differently, it should be noted that some markings are likely to remain after the operation.

The scars left by incisions tend to resemble stretch marks. There are techniques wherein the incision is made only around the nipple, others wherein there is one incision around the nipple and a second, vertical one beginning from the nipple and stretching towards the under-breast, whereas in other techniques the incision are made around the nipple, one vertical and one horizontal (in the shape of an anchor).

Often the patient will have to pick a better shape for the breast requiring more incisions, or a less satisfactory shape requiring fewer incisions.

Experience has shown us that the most important of the two is a good breast shape. When a patient’s breast shape is satisfactory, they are usually able to ignore the incisions and not be bothered by them. In any case, after a few months the incisions tend to heal quite well, and as such do not cause much annoyance.

BEFORE THE BREAST LIFT

Before the operation a rather lengthy discussion is required as far as the type of the procedure is concerned, as well as the advantages and disadvantages of each option. It is likely that you will need to take a mastography, which is a radiography of the breasts, in order to confirm that there are no abnormalities.

Avoid the use of aspirin and alcohol up to 10 and 2 days before the operation respectively. In addition, if possible, avoid having the breast lift done while on your period, or even a few days before it. We emphasise this because during the menstruation period, or even slightly before it, patients are particularly sensitive to pain and the ability of their blood to clot is reduced, which can increase the chance of complications.

In addition, during this time the breast may be swollen, and as such present a different appearance than it does usually. This can give the plastic surgeon a false idea of the problem and confuse them into taking incorrect measurements.

DURING THE OPERATION

It is vital that the operation be performed under good conditions in a well-organized space. Typically, localized anaesthesia is administered, this being the safest type, provided the patient is not suffering from serious health problems.

The duration of the operation depends on the degree of sagging in the breasts, as well as the technique used. It usually varies between 2 and 4 hours. The surgeon restores the nipple to a more elevated position, removes excess skin, and attempts to secure the bulk of the breast at its new position.

It is likely that at the end of the procedure some vents will be put in place (small tubes that aid in the outward drainage of any and all liquids that may have accumulated in the breast after the operation). These tubes are usually left in place for one day, or may be required to be left for longer.
Usually, the patient only remain at the clinic for 24 hours afterward.


AFTER THE OPERATION

Once the patient has returned home they will be in a position to return to their daily routine without issues, from the very first day. Usually, the pain is meagre to non-existent, and in the few cases where a greater degree of annoyance is noticed, appropriate painkillers can deal with it quiet well.

A return to work can be made after 4-6 days, if the patient has an office job. If their occupation requires quite a lot of mobility, they may need up to two weeks of rest before they can resume work. The vast majority of patients, however, are able to return to work within one week of a breast lift operation.

Heavier manual work, such as exercise, is permitted after one month. The sutures are absorbable, and therefore do not need to be removed. One can bathe comfortably 2-3 days after the operation, but sea bathing is only allowed after approximately one and a half month.

The breast will initially display some swelling, and possibly some bruises; therefore, it is not initially presentable, and its shape does not reflect the final result. It will begin to improve after the first month, and adopt its final shape after 6 months.

The mammary gland is not affected, and therefore female patients are able to breastfeed just as they used to before the operation. The results persist for several years, provided there are no large fluctuations in the size of the breast.

Breast lifting is frequently combined with breast augmentation. In this case the lift is performed as usual, but at the same time a silicone implant is deposited into the breast. The implant is benign, as it improves the final shape of the breast even further. It is however unnecessary, assuming the patient does not wish to increase their breast size, but rather is satisfied by its current volume.

On occasion, the degree of sagging in the breasts is very small and only an implant is needed to correct the breast, thus rendering a complete lifting obsolete. This type of procedure, however, requires a particular knowledge of the subject, as it has some idiosyncrasies. Provided the plastic surgeon is well acquainted with these idiosyncracies, they should be able to achieve a very satisfying shape for the breast without needing to perform a lifting.

In order for the patient to obtain results they are satisfied with from this operation, it is essential that they be fully and correctly informed, and have the process explained to them in detail. When these factors are satisfied, the level of satisfaction from a breast lift is very high.