In the course of a woman’s life, the breasts often change in size, shape, contour and position resulting in sagging (ptosis) and loss of breast tissue elasticity. These changes can be exacerbated by pregnancy, breastfeeding, ageing, weight fluctuations, genetics and gravity.
Breast lift surgery (mastopexy) is a cosmetic surgical procedure to correct the size, contour and position of sagging breasts. This surgical procedure involves removing excess tissues (skin, fat and breast tissues), reshaping surrounding breast tissue and reposition the nipple-areola complex to create new youthful and uplifted breasts. Breast lift surgery does not significantly change the size or create a fuller upper part of the breasts. To achieve fuller breasts, a combination of breast lift and augmentation surgery can be performed. Likewise, if smaller breasts are desirable, breast lift and reduction surgery may be considered.
There are a variety of techniques for breast lift surgery. The selection of appropriate methods and incision patterns are determined by:
- Breast size and shape
- The size and position of the nipple-areola complex
- The degree of breast sagging
- Skin quality and elasticity as well as the amount of extra skin
The typical incision patterns for breast lift surgery are:
- Periareolar incision: around the areola incision
- Lollipop incision: around the areola and vertically down from the areola to the breast crease
- Anchor incision: around the areola, vertically down from the breast crease and horizontally along the breast crease
Following the incision made, the breast is reshaped by:
- Lifting and reshaping the underlying breast tissue to improve breast contour and firmness
- Repositioning the nipple and areola to a natural, more youthful height
- Reducing the enlarged areolas (if necessary) by excising skin at the perimeter
- Removing excess breast skin to compensate for the loss of breast tissue elasticity
Ideal candidates for breast lift surgery
- Loss of breast shape and breast sag after pregnancy, weight loss, or with ageing
- Breasts that are flatter, elongated shape or are pendulous
- Unsupported breasts (without a bra), the nipples fall below the breast crease
- Nipples and areolas pointing downward
- Stretched skin around the breasts and enlarged areolas
- Unequal position of the breasts
- Healthy individuals who do not have medical conditions that can impair healing or increase the risk of surgery
- Individuals with a positive outlook and realistic expectations
- Non-smokers
Preoperative evaluation for breast lift surgery
Communication is vital to achieving the patient’s goals. During the initial consultation, patients will have the opportunity to discuss their goals and desired results with the plastic surgeon. The plastic surgeon will work closely with the patients to reach an agreement about the expectations from the surgical procedures involved and their long term benefits. Every patient is different. Therefore a specific treatment regimen is planned to suits an individual’s need. The preoperative evaluation for breast lift surgery includes:
- Discussion about patients’ expectations and desired outcome
- Medical conditions, drug allergies and previous medical or surgical treatment
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
- Discussion on anaesthesia and its risks
- Physical examination
- Breast examination including detailed measurements of their size and shape, skin quality, placement of nipples and areolas
- Photography for preoperative and postoperative evaluation
Preparation for breast lift surgery
- Get laboratory testing or a medical evaluation
- Get a baseline mammogram before surgery and after surgery to help detect any future changes in the breast tissue
- Adjust medications if for specific medical conditions
- Stop smoking and alcohol well in advance before the scheduled date for surgery
- Avoid taking aspirin, anti-inflammatory drugs and herbal supplements before surgery
- Special instructions will be given on the day before and after surgery
The risks and safety information on breast lift surgery
It is crucial for patients to understand that every surgical procedure has its complications and downtime. However, if a patient is assessed correctly before the surgery and postoperative care is given adequately, these risks can be eliminated or reduced.
Some of the common risks of breast lift surgery:
- Infection
- Bleeding
- Poor wound healing
- Wound breakdown
- Skin discolouration
- Swelling due to a blood clot or fluid accumulation
- Fluid accumulation
- Unfavourable scarring (hypertrophy or keloidal scar)
- Temporary numbness or changes in the skin sensation around the nipple or breast
- Breast contour and shape irregularities
- Excessive firmness of the breast
- Potential partial or total loss of nipple and areola
- Asymmetry
- Injury to deeper structures such as nerves, blood vessels or muscles
- Possibility of revision surgery
- Anaesthesia risks
Postoperative expectations
After the surgery, temporary dressings or bandages are applied to the incision sites. Small tubes may be temporarily placed under the skin for 24-48 hours to remove any excess blood or fluid that may be collected after the surgery. During the first 2-3 days, there may be discomfort, swelling, bruises and tightness around the breasts. Once the tubes and temporary dressings are removed, the patient is advised to wear a sports bra (for 4-6 weeks) to minimise the swelling and support the breasts during the healing phase. It is advisable to avoid strenuous activities such as heavy weight lifting or vigorous exercise for the first 4-6 weeks after the surgery. However, that, light physical and social activities can be resumed from the 7-10 days after the surgery. Oral antibiotics and analgesics will be prescribed to reduce the risk of infection and postoperative pain respectively. Stitches will be removed on 7-14 days after the surgery. The symptoms of discomfort, swelling, bruises and tightness around the breasts may disappear completely about 3-4 weeks after the surgery, but the breasts may gradually take several months or a year to soften and feel more natural.
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Postoperative care
- Regular application of antibiotic ointment and cleaning the operated areas for the first one week after the surgery
- Bed rest with arms elevated to reduce swelling
- Avoid excessive arm movement or weight lifting for the first 4-6 weeks after surgery
- Arm movement should be limited for up to 4-6 weeks following the surgery
- Wear sports bra (no underwire bra) for 4-6 weeks after the surgery
- Regular use of scar gel and massage after the surgery to improve the scar and breast shape
How much will a breast lift surgery cost?
Cost is always a consideration in elective surgery. The cost of breast lift surgery can vary widely.
The cost of breast lift surgery may include:
- Surgeon’s fee
- Hospital or surgical facility costs
- Anaesthesia fees
- Medical tests and x-rays
- Breast implants (optional, if breast augmentation surgery is performed)
- Prescriptions for medication
Breast lift surgery is a cosmetic surgical procedure, and most of the health insurance does not cover cosmetic surgery or its complications.