Breast Lift (Mastopexy)
A breast lift, or mastopexy, is performed to return youthful shape and lift to breasts that have sagged as a result of weight loss, pregnancy, loss of the skin’s natural elasticity or simply the effects of gravity. The procedure can also reduce areolar size (the dark skin surrounding the nipple), and it can be combined with mastopexy (breast augmentation) for added breast volume and firmness. Breasts of any size can be lifted, but results last longest when they are originally small and sagging.
Dr. Michele Koo advises women planning to have children to postpone surgery, since pregnancy and nursing can counteract its effects by stretching the skin. However, mastopexy should not affect your ability to breast-feed.
Mastopexy may be performed in a hospital, an outpatient surgery center or Dr. Koo's office-based facility. It is usually done on an outpatient basis under general anesthesia, and lasts from 1-½ to 3-½ hours.
A number of pre-operative steps are typically taken such as a mammogram, measurement of the bustline, and discussion with Dr. Koo about the desired size and shape of the breast and placement of the nipple. During the procedure an anchor-shaped incision is made from the location of the new nipple down to and around the crease beneath the breast. Dr. Koo removes excess skin, relocates the nipple and areola, and reshapes the breast using skin from around the areola before closing the incisions with stitches.
Patients with small breasts and minimal sagging may be recommended for smaller-incision mastopexy. One such modified procedure is concentric ("doughnut”) mastopexy, in which two concentric circular incisions are made around the areola and a doughnut-shaped swathe of skin is removed.
After surgery the breasts are wrapped with gauze dressings, over which an elastic bandage or a surgical bra is placed. After a few days this is replaced with a soft support bra which is worn 24 hours a day for about a month. Breasts will probably be bruised, swollen, and uncomfortable for a few days but this will pass. Numbness in the breasts and nipples should lessen as swelling subsides, although occasionally it lasts for months or even permanently. Stitches are removed after one to two weeks, and many patients return to work then.
Complications are uncommon but may include bleeding, infection, numbness, uneven positioning of nipples and widenening of scars. Scars can be covered even beneath bathing suits and low-cut tops.
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