Breast lift

This is best decided during a consultation, but generally speaking this operation is beneficial for women in good physical and mental health, who have reasonable expectations of surgery that will raise and reshape sagging breasts.

Large breasts can be lifted, but because they are subject to the forces of gravity to a greater degree than smaller breasts, breast reduction surgery may be a more suitable option. Likewise, breasts which have lost substance after breast-feeding, or weight loss may not be restored to their former glory, simply by lifting them during a mastopexy; in order to truly rejuvenate them, you may benefit from combining a mastopexy with breast augmentation.

If you are planning to have children it is best to postpone your breast lift. Pregnancy will stretch the skin of your breasts and breast-feeding will usually decrease the substance of them. Inevitably therefore, the cosmetic results of a mastopexy will be diminished – rather than repeat it later, you might prefer to wait till your family is complete!

After mastopexy there is a theoretically-increased risk that breast feeding may not be possible – although, because it is usually a less radical operation than a breast reduction, it is less likely to damage your breast-feeding capability. That said, whether or not this type of surgery interferes with breast-feeding is contentious and several studies of women who’ve undergone the more radical operation of breast reduction, suggest their ability to breast feed after surgery is equivalent to an age-matched population of women who have not had surgery.

Nipple sensation may decrease after surgery, but is less likely in mastopexy than in the larger operation of breast reduction.

The blood supply to the nipple and areolar skin may be compromised and part or all of one or both nipple-areolar complexes may die as a very rare complication of mastopexy and is more likely in people who smoke or have diseases affecting the small blood vessels to the skin.

Finally, the colour of nipple-areolar complexes may lighten or darken after surgery: this is more likely in dark skinned races or after infection.

Cancer screening may be more complicated after a mastopexy in so far as damage to fat and alteration of the breasts’ architecture may make interpreting mammograms harder. Generally, if women over 35-years-old have a base-line mammography before surgery and then again after their mastopexy has settled at say, 6 months after the operation, to give a Radiologists the potential for comparison later, there is unlikely to be a problem.

During your consultation, I will take a full medical history. I will ask you specifically about any breast disease you have suffered, as well as any previous surgery you may have undergone and about your family’s history of breast diseases such as cancer. If you have had mammograms, I will need to know the results. I will also ask about your desired breast size and shape and anything else related to the appearance of your breasts that you feel is important.

I will examine you completely, then focus on your breasts to assess their size, symmetry and shape and the quality of their skin envelope. I will then take standardised photographs in order to help plan and discuss your operation. Finally I will measure you for a sports-type bra, which you will choose and bring with you to be used as a comfortable dressing over your surgical dressings in the days immediately after your surgery.

By all means bring pictures from magazines to show me examples of women who seem to have breasts of a size that equate with your desired breast size – these will be useful in discussion.

The technique I use for your mastopexy will depend on the size, symmetry and position of your breasts on your chest wall. I will minimise skin incisions as far as is compatible with providing you a predictable, stable and aesthetic breast shape. There will always be a scar around the areolar skin and vertically down to the skin fold under the breast; thereafter a scar in the skin fold beneath the breast may be necessary, but will be minimised. The bulk of the operation involves repositioning your nipple and areolar skin within repositioned and sculpted breasts.

On occasion I may use liposuction to remove fat from the armpit area to improve the aesthetics of your breast and torso.

When a mastopexy is combined with augmentation, the implants are placed in surgically created pockets beneath the newly formed breast or below the pectoral muscles on the chest wall.

Before surgery, you will meet and be assessed by your anaesthetist who will prescribe medications for your comfort and to lessen anxiety if need be.

On the evening before, or the morning of your operation I will review what we have discussed and planned previously and we will both sign your operative consent forms. Then, with you sitting upright, I will measure and draw guidance marks for surgery on your chest and breasts.

The operation is performed under General Anaesthesia – you will be asleep. The operation usually takes 1-2 hours, depending on the technique used. After surgery, you will awake in a recovery area and soon afterwards you will be returned to your room. A drain is placed under the incision in each breast to remove the normal healing fluid that the body produces and stop it accumulating within your reduced breasts. These drains will be removed when the drainage is minimal – usually after a day or two and once they have been removed you can shower normally. Most patients go home a day or two after surgery on simple pain relieving medications and a short course of antibiotics.

You will feel tired and somewhat sore for a week or two following your surgery, but you will be able to move around and function relatively normally.

You will have buried, soluble stitching which will dissolve and doesn’t need to be taken out.

Generally, you can return to work if your occupation is sedentary, after 3 – 4 weeks, but if your work involves heavy lifting or is strenuous in other ways, for instance women police officers, 6 – 8 weeks might be a more realistic period off work. So long as you can do so with due care and attention, you can begin driving 3 – 4 weeks after surgery.

You should restrict yourself to light exercise for 2 – 3 weeks – avoiding lifting anything over 5Kg and aerobic exercise for at least 3 weeks.

Your breasts will be swollen for at least 6 – 8 weeks, but at that stage your new breasts will have attained almost their final appearance. Your final operative result will continue to mature for 3-6 months and your scars will continue to mature for up to a year.

New scars benefit from friction-free massage (using vaseline, for instance, to lubricate the massaging process). Beginning to massage scars two to three weeks after surgery, will help them mature, soften and flatten faster than if left to their own devices. New scars should be protected from sunlight for 2 years to avoid them pigmenting differently to the surrounding skin and becoming a different colour permanently. Factor 15 sun block should be applied whenever they are exposed – even to a British winter sun.

In the longer term, final size, shape, symmetry and aesthetic result of breasts after reduction surgery will vary according to individual factors which are due to genes, life style, life events and gravity. After surgery, lack of support, alterations in weight or hormonal variation may alter your breasts’ appearance and symmetry markedly.