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 is, the greater the chance is that it will undergo sagging.
Therefore, larger breasts are almost certain to undergo a loss in firmness after a certain period of time, due to gravity.
The most common 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 back to its natural place, which had dropped to a lower position.
This procedure has no relation to breast augmentation. These are two entirely different surgical procedures 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 has been dropped to a lower position. A further problem is that sagging have manifested in the various feature that compose the inner gland. Therefore, a breast lift 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 shape as possible.
BREAST LIFT TECHNIQUES
Over time, several different techniques have been developed for breast lift operations. When there are such a variety of techniques available for a procedure, we can be certain that neither is perfect and each one 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 women 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 practically 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 inframammary fold (lollypop shape technique), whereas in other techniques the incisions are made around the nipple, one vertical and one horizontal (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 more important among those two options is a good breast shape. When a woman’s breast shape is satisfactory, she is 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 mammogram, which is radiography of the breasts, in order to confirm that there are no abnormalities.
Avoid the use of aspirin and alcohol up to 10 days before and after the operation. In addition, if possible, avoid having the breast lift done while on your periods, or even a few days before it. We emphasize 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 him into taking incorrect measurements.
DURING THE OPERATION
It is vital that the procedure is going to be held under good conditions in a well-organized establishment. Typically, general anaesthesia is administered, this being the safest type.
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 plastic 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 drains 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 some days more.
Usually, the patient only remains at the hospital for 24 hours afterward.
AFTER THE OPERATION
Once the patient has returned home, she will be in a position to return to her daily routine without issues, from the very first day. Usually, the pain is meager to non-existent, and in the few cases where a greater degree of annoyance is noticed, appropriate painkillers can deal with it.
A return to work can be made after 4-6 days, if the patient has an office job. If her occupation requires quite a lot of mobility, she may need up to two weeks of rest before she can resume work. The vast majority of women, however, are able to return to work within one week after 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 patient is able to breastfeed just as she could do before the operation. The results lasts 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 placed into the breast. The implant is beneficial, 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.
There are many cases in which the degree of sagging in the breasts is very small and only an implant placement is enough to correct the breast, thus rendering a complete lifting unnecessary. This type of procedure, however, requires a special knowledge of the subject, as it has some particularities. Provided the plastic surgeon is connoisseur of these particularities, he 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 satisfactory results, it is essential that she is fully and correctly informed, and have the process explained to her in detail. When these factors are fulfilled, the level of satisfaction from a breast lift is very high.