| Pre: A 52 year old patient with sagging breast.
|| Post: Short scar breast lift.|
|| Post: Short scar breast lift.|
Low, Drooping breasts
Mastopexy breast lift plastic surgery is one of the more common procedures as it can be done to lift the breast, reduce breast size or be combined with a breast augmentation. The principles are similar as the ratio of skin to breast tissue is adjusted to an equilibrium. Mastopexy surgery shapes and lifts the breast. It does not reduce the volume appreciably (since some excess skin is removed the breast volume does drop a small amount), and it does not increase breast volume.
FACTORS TO CONSIDER
- Previous pregnancies
- Smoking history
- Last time breast feeding
- Desire to increase or decrease volume
- Position of breast on the chest
- Overall health
With breast lift surgery the ideal result is having a nipple at the level of the fold where the breast meets the chest or inframammary fold a proportion that is balanced, there should be an equilateral triangle from nipples to the sternal notch, the nipples should face slightly outward (they turn in with time), the breast mass should start 2cm from the midline (they come in with age and look old when leaning forward in a blouse), and the general shape should be youthful and round-skin allowing.
In younger and athletic women, the nipple is above the fold, it sits almost directly centered on the mound in the lateral view. Secondly, the breast with the nipple at the level of the fold, it tends to age more rapidly and descend.
There are hundreds of types of breast lift procedures. The optimal procedure depends upon your physical examination and wishes.
Lateral Breast Lift
A small wedge is taken laterally, lifting the breasts and pushing them medially. This leaves a fine scar and works on small breasts. This pushes the nipple more medially.
Vertical Breast Lift
Incisions around the areola and down to the inframammary fold. This breast lift procedure is very versatile, avoiding the transverse incision... but has limitations in vertical reduction of breast skin and limits some shaping. Incisions require time to settle and may require revision at the fold.
Wise Pattern Breast Lift The most common form of mastopexy. Allows the most shaping on all sizes. Scar is around the areola, down and into the fold. Scars in the fold may be an issue. The vertical tends to heal well. The areolar may widen with time.
Periareolar Brest Lift
Pulls skin around the areola. For small lifts, lifts with implants and those concerned about scars elsewhere. Leaves bottom half of breast round. Scars can widen with time but are easily revised. Also may flatten areola.
All are performed under sedation in our clinic surgical suite unless medical reasons or insurance mandates. You do not feel nor remember anything and are not paralyzed for breathing. The procedure is 2.5-3.0 hours.
3 days. Our techniques do not involve the muscle. Pain is very mild and reduced by mild steroids and pain pills. Showering can occur the next day. Sutures are dissolvable. There is some bruising but that fades after 10 days. The results are immediate. Some bulges and swelling occur and resolve over 3 weeks.
No surgery is without risks. There will be bruising, temporary changes in sensation, and scarring (the lift can't occur without some skin removal and that can only happen with an incision).
Bleeding requiring treatment and infection are rare (I haven't seen them) but are possible. The scars can be an issue and may require a revision under local. The shape can change and bottoming out can occur. This is less with newer techniques but not zero. This requires a revision usually under local. Areolar scars can also require revisions (one plastic surgeon said at a meeting "no revisions, not operating" - true).
On 2 occasions, I felt an abnormal lump during the surgery, not seen on a mammogram. I removed the lumps with a 2 cm margin. They were cancerous. These women were cured due to the removal. Other risks are asymmetry, lumps, contour differences, different colored scars, raised scars, excess firmness.
Rarely, the nipple - areolar complex may become compromised, especially after previous surgery. This may require immediate attention although when left to heal on its own, often leaves a good result.
A mastopexy does not stop time, nor gravity. In my experience, the breasts have never returned to the original sagging position, but may be re-lifted at a later date with a simple removal of excess skin inferiorly.