Breast Lift (Mastopexy)

Breast Lift (Mastopexy)

What is a breast lift?

A breast lift, also known as breast lift surgery or a mastopexy, is surgery to restore uneven and sagging breasts, making them firmer and perkier. The surgery is also able to rectify stretched areolas, which are the darker areas around your nipples, as well as plump up decreased breast volume. It can be performed at the same time as breast augmentation or a breast reduction if the breasts have too little or too much volume.

The surgery involves removing the excess and stretched out skin, raising the nipple and areola to a position that is more forward, and reshaping the breast tissue. This creates a more youthful contour (shape) of the breast.

Every year, thousands of women undergo the common procedure of a breast lift and are often pleased with the results, feeling as though their feminine proportions and confidence have been restored.

A breast lift reshapes and resizes your breasts through the removal of excess skin, creating a new breast contour and a youthful appearance.

The benefits of a breast lift

There are a number of common reasons why women choose to have a breast lift done, these being:

  • A breast lift is able to restore breast shape after pregnancy and breast feeding. Pregnancy can result in the breasts sagging and stretching. A more aesthetically pleasing appearance can be attained through a breast lift which aids in correcting these negative affects on the body.
  • A breast lift is able to improve breast contours and overall look of the breasts after significant weight loss. Weight loss often results in excess skin on the breasts, which can then be removed to restore a more youthful and proportional breast.
  • A breast lift can help a woman to have the firm and perky breasts she has always wanted. Some women have always had naturally droopy breasts and others have started to sag with age. A breast lift restores the breast contour, allowing women to experience perky, aesthetically pleasing breasts.

Breast lift considerations

Every cosmetic surgery has its pros and cons. A breast lift has its own considerations to be aware of before having the procedure done. These are:

Pros

  • Your breast shape will be improved, as well as the projection and symmetry.
  • Your confidence will be boosted and you will look better in clothes and swimsuits.
  • Your breasts will appear more youthful.

Cons

  • The effect of the breast lift might diminish over time due to aging and gravity.  How long results last may also depend on the elasticity of your skin.
  • A breast lift will leave scars (although these can be hidden by wearing a bra or a swimsuit).
  • If you fall pregnant after a breast lift, the results may be compromised.

How to tell if you should get a breast lift

If you start to become increasingly disappointed about your boobs sagging or their overall appearance, it is normal to start to wonder about the benefits of surgery.

Your surgeon may also suggest that you combine a breast lift with a reduction or even breast augmentation, in order to get the best look for your breasts. The best way to determine if a breast lift is suited for you, is to speak to a qualified plastic surgeon.

There are a number of questions you can ask yourself if you are considering a breast lift. If your answer is yes to some or even one of these questions, a breast lift may be the best route for you to go in:

 Breast shapes

  • Do my breasts lack firmness and substance?
  • Are my breasts pendulous (drooping) but are they an adequate size?
  • Do my nipples and areolas point downward? Specifically, if they are positioned below my breast crease? ** Tip – a good test is to slide a piece of paper under your breast, without wearing a bra, so that it sits against the breast crease (under your breast). When you look in the mirror, see if your nipples are sitting below the top edge of the piece of paper (i.e. hanging over the paper). If they are, it is an indication that a breast lift to improve sagging is warranted.
  • Do my breasts appear different from each other? Do they differ in contour and position?
  • Are my breasts relatively small in size?
  • Do I want to have children and breastfeed in the future? If so, it may be a good idea to hold off on a breast lift until after children, as pregnancy and breastfeeding lessen the result of surgery.
  • Am I in good health with a positive attitude and realistic expectations?

The different types of breast lifts

There are a variety of different incision techniques used for breast lift surgery. They are based on your existing breast tissue, the amount of excess skin that needs to be removed and your individual goals for the outcome of the surgery. These types are:

The anchor incision

Also known as the inverted T, it is used to correct considerable sagging and for the dramatic reshaping of the breasts. There are three incisions involved in this technique, and it often results in the worst scarring compared to other techniques. The incisions are: vertically from the base of the areola to the breast crease, another along the breast crease and the last one around the areola. This is one of the oldest techniques and is used in conjunction with a breast reduction.

The crescent lift

This technique is less commonly used. The incision is along the upper part of the areola and is normally done in conjunction with breast augmentation as it is suited for women with minimal sagging. This is because it cannot achieve the same amount of lift as the other techniques.

The lollipop lift

This is also known as the keyhole incision, which is made around the areola edge and another from the areola to the breast crease. The incision creates a ‘lollipop’ shape, which some say is also a ‘keyhole’ shape, and the scars are modest and easily hidden. It is best used to reshape and correct moderate sagging.

The doughnut lift

This technique is able to correct moderate sagging with just a single scar. It is also known as a peri-areola lift. Like the crescent lift, it is often performed with a breast augmentation and it can also reduce the size of the areola. The incision goes along the edge of the areola. 

How to choose the best surgeon for you

The choice of your surgeon should be based on the following:

  • Training, education and certification
  • Experience
  • Your level of comfort around them

Do some research and ask around to others who may be able to get you in touch with a surgeon. Choosing your surgeon is the most important decision to make and you need to feel confident and comfortable with your choice.

Ensure that they are board-certified and that the surgery will take place in a facility that is accredited. It is important not to choose a surgeon based on price, your safety and results are the crucial factors here, and many surgeons offer some kind of financing options.

What to expect from your first consultation

When you see your surgeon for the first time, ask to see before and after photos of previous patients, ask about how many surgeries they have performed.

When you first walk into the consultation room, the surgeon will ask you some questions about what you want to achieve and what your issue with your breasts is. It is vital that you ask any questions that you may have in order to clear up the confusion you have about the surgery. If you do not feel comfortable with a specific plastic surgeon, you do not have to choose them and you should meet with a few others to find one that makes you feel comfortable, answers all questions to your satisfaction and does not pressure you into the procedure. Your consultation with a surgeon does not mean you have to have them perform the breast lift. However, consultations always come with a fee.

Your surgeon will most likely ask you to go into a room or behind a curtain and take off your top and bra. There will be a gown hanging up or on the bed for you. He/she will then come into the room and assess your breasts.

The surgeon will then consider the following:

  • The size of your current breasts.
  • The shape and size that you want.
  • The amount and quality of your current breast tissue.
  • The skin quality of your breasts.
  • The nipple and areola placements.

Your surgeon will measure, photograph and examine your breasts while assessing them, he/she may also recommend that you have another surgery such as a breast augmentation in conjunction with the breast lift. The surgeon should also talk about what incision method will be best for you.

To photograph your breasts, you will be asked to remove your bra and stand against a wall in the room. Photographs will be taken from the front and of both sides of the boobs. Many women feel uncomfortable with this, however, this is purely for professional purposes when planning the surgery and for “before and after” results comparison and your surgeon should not make you feel uncomfortable during your consultation. Bear in mind, it is a very intrusive surgery and some kind of personal discomfort is expected.

You will also need to disclose certain medical information about past surgeries, any medical conditions you may have, your mammogram results, treatments you have received and allergies to any medications. You will also need to tell him/her if you are planning to become pregnant or lose a large amount of weight. You may be asked to get to your goal weight before surgery as this will impact the amount of excess skin of the breasts. It is also sometimes advised to wait until after you have had a child to have the surgery as pregnancy can negatively impact the results of the surgery.

How to get ready for surgery

You will be provided with extensive preparation instructions from your surgeon. You may also be given dietary requirements and weight benchmarks to reach before the surgery.

Your surgeon will ask the following of you prior to the procedure:

  • Stop smoking for at least six weeks (if you smoke)
  • Keep hydrated
  • Avoid aspirin as this can increase bleeding
  • Limit alcohol consumption
  • Eat a high-protein, low-sodium diet

Your surgeon will also ensure that you have arranged for someone to drive you home after the surgery as you will have limited use of your arms and will still feel drugged from the anaesthetic.

During the breast lift surgery

Your surgeon will often ask you to be at the hospital, office-based surgical suite or ambulatory facility, a few hours before the procedure. You will also not be able to drink or eat anything at least six hours before.

Upon arrival at the hospital, you will then be admitted and asked to change into the not-so-flattering surgical robe and underwear. Your surgeon will then meet you in your room and talk to you about the length of the surgery and the plan of action. He/she will try and make you feel as comfortable as possible. He/she may also draw the incision marks on you prior to the surgery.

You will also meet your anaesthetist as you will be under general anaesthetic for the length of the procedure. Once in the operating room, various monitors will be placed on your chest and back to check your heart, pulse, blood pressure and oxygen levels. The surgery will take about one to two hours, depending on the extent of it. Once beginning the operation, your surgeon may adapt the chosen technique to ensure the best results.

After the surgery, your surgeon will wrap a bandage around your breasts or you might have to wear a surgical bra. You will then be wheeled on the hospital bed into the recovery room where you will be closely monitored as you begin to wake up. You will most likely be allowed to go home within a few hours, but your surgeon may have other recovery plans, it is best to speak to him/her about the process after the operation. You may also have drains in to collect excess fluid from your breasts, these will have a long pipe going into a hole in your breast with a small bag at the end of it, for the collection of the fluid. Some doctors prefer not to use these. You will normally have these removed one week after surgery.

What to expect after surgery

Your surgeon will normally prescribe pain medication as you will be in a lot of pain and discomfort. You will also experience swelling and have very little movement of your arms. Try and take it easy for the first few days. You are able to walk around, but you will still be in pain. It is sometimes best to have someone stay with you to help carry things, reach items higher up (it will be sore to lift your arms) and help you to sit up from lying down.

You will be expected to sleep on your back for the first few weeks after surgery. It helps to surround yourself with pillows that will prevent you from rolling onto your side or stomach. You will have to wear and sleep in your surgical bra for about four weeks. Some surgeons may issue two bras so that one can be washed while you wear the other one.

It is possible to return to work after about four days of recovery, but this is purely dependent on your surgery and recovery. Often having another surgery in conjunction with a breast lift, such as breast augmentation, may result in a longer recovery time. Exercise should be limited in the first four weeks, after which you can start easing back into your exercise routine. Speak to your surgeon about recovery and exercise. You will be allowed to wear an underwire bra eight weeks or possibly sooner after your surgery.

Your surgeon will typically want to see you once a week for the first four weeks, and then at six months and finally, at one-year post-op. However, depending on the surgeon and the procedure, these assessments may vary.

Some settling of the breasts will occur in the weeks after the surgery, but the nipple placement should remain intact.

Keeping your breasts looking great

Certain life events such as pregnancy, weight gain, ageing and gravity can adversely affect the results of your surgery. However, depending on the individual, the results are normally long-lasting. It is important that you maintain a relationship with your surgeon so as to monitor any changes.

If the surgery has been performed properly, your breasts should maintain their postoperative appearance for decades.

Breast lift with augmentation

The possible complications of a breast lift

Complications with breast lift surgery are infrequent, and your personal risks will be discussed with you during your consultation. However, every procedure does have risks, and complications of surgeries are:

  • Negative reaction to the anaesthetic
  • Seroma or hematoma (blood or fluid accumulating under the skin that might have to be removed)
  • Allergic reaction to medication
  • Bleeding or infection
  • Blood clots in the lungs or legs
  • Scarring
  • Unsatisfactory results which can lead to further surgeries

These risks are often minimised through having a certified surgeon and disclosing all your medical information and history to him/her. It is important, to be honest with your surgeon in order to ensure a successful surgery.

Some more questions about breast lifts

Does insurance cover my surgery?

Breast lifts are commonly considered to be a cosmetic surgery which are not covered by medical aid. Unless they are done as part of a mastectomy reduction, in which case your health insurance may cover the costs. Speak to your provider to clear up any questions you may have about your health insurance.

Will I ever need another breast lift?

Some women may need a ‘touch-up’ breast lift surgery. Whether you require this or not is dependent on the elasticity of your skin, if you fall pregnant and breastfeed after the surgery, experience weight gain and also the effects of ageing (which no one can accurately predict). However, should this be necessary, it will not be a complete procedure, but rather a minor one in comparison to the initial surgery.

Can I still breastfeed after a breast lift?

Once your breasts have finished developing, you are able to get a breast lift at any age. It is also possible to get one before or after pregnancy and you will still be able to breastfeed.

What will my breast lift incisions and scars be like?

Your scars will be dependent on the type of incision that your surgeon performs. Most incisions can be concealed in the natural lines of the breasts, but others might be more visible on the surface of the breast.

Over time, your scars will fade and improve significantly. Your surgeon should make every effort to ensure that your scarring is minimal. Speak to your surgeon about scar treatment options.

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