What is a Breast Lift?

Many women refer to a breast lift as restoring perkiness to their breasts, or returning to their pre-baby breast. Over time, breasts can lose their shape , size and firmness due to pregnancy, nursing, loss of skin elasticity, the natural atrophy of breast tissue after having children, or massive weight loss. The resulting loose skin causes the breasts to sag and lose their form and youthful appearance.

A cosmetic breast lift surgical procedure can be performed either with or without implants. The breast is lifted and reshaped, and the loose skin is removed to restore a more youthful look. If you desire breast augmentation to restore upper breast fullness and your cosmetic surgeon recommends a breast lift at the time of your breast augmentation, this is important to avoid residual breast ptosis, or a “Snoopy Nose” deformity  You need to keep in mind breast implants will only restore size and fullness of your breast they  will not restore the perkiness. 

Your Consultation

It is important to find an experienced and trained cosmetic surgeon who can successfully perform your breast lift surgery. Do your homework. Ask to review your surgeons’ before and after photos of their breast lift patients. Your surgeon should listen to your expectations, take a complete medical history, and conduct a thorough examination to evaluate your overall health. Ideally, the Breast Lift and augmentation patient has no health problems, no pre-existing breast disease, and wishes only to improve the shape and appearance of the breast. Most patients over 35 years old will be required to have a normal mammogram performed within 6 months prior to the procedure.

 The Breast Lift Procedure

Breast lift surgery is performed in a certified outpatient surgery center or a hospital. You should ensure that your cosmetic surgeon is credentialed to operate at such certified facilities. A breast lift surgery can take between 2 to 5 hours, depending on how much excess skin needs to be removed. If the patient has lost massive weight after bariatric surgery surgery may be longer. The type of breast lift procedure that is needed is determined based on the degree of sagging, or ptosis, which exists. It is natural to desire the shortest scar possible, and some patients find it difficult to understand why longer scars are sometimes needed. Generally, the more the breast has descended, and the more excess skin that exists, the more extensive the surgery needs to be and the longer the scar will be. A cosmetic surgeon always strives for the shortest scar possible, and typically utilize one of four techniques:

• The peri-areolar, or “donut” mastopexy removes a small circle of skin from around the areola (the more darkly pigmented skin surrounding the nipple.) The nipple is moved to a higher position on the breast, while remaining attached to nerves and blood vessels. The remaining skin is tightened around the now smaller areola, resulting in a lifted breast. This method results in a circle scar around the areola. It is only appropriate for select patients with a small degree of sagging who require only a small (3cm max) lift.
• The “crescent” lift is a variation of the peri-areolar mastopexy where a small ellipse of skin is removed from around the areola to slightly reposition the areola either up or to the side (1cm max) to enhance the symmetry between breasts. This method is appropriate for women with minimal sagging but with asymmetry in the position of the nipples on their breasts and is usually performed as part of a peri-areolar breast augmentation if the patient wishes to have the nipple asymmetries corrected. The resulting scar is a semi-circle at the junction the areola and skin.
• The vertical, LeJour, or “lollipop” mastopexy utilizes an incision that encircles the areola and then descends vertically to form the namesake lollipop shape. The addition of the vertical incision allows for more skin and tissue to be removed from the lower part of the breast. The nipple and areola are re-positioned higher on the breast mound, and the skin surrounding the areola is then brought together to reshape the breast. This method allows for the correction of moderate sagging and results in much less scarring than the traditional anchor-shaped Wise pattern mastopexy. If patients have severely sagging breasts with a lot of excess skin, then this incision is extended as needed along the lower fold of the breast to achieve the desired result with the minimal amount of additional scarring. For patients who have lost significant weight after bariatric surgery and have lots of excess skin on the side of their chest, this incision can be further extended to create an upper side-body lift.

In a Mastopexy, several layers of hidden sutures are used, and the final incisions are covered with surgical tape. Although very rare, a small suction drain may be placed behind the breast to avoid fluid accumulation if necessary. This drain is usually removed within 2 to 5 days.

 Risks

Anyone considering any type of surgery should be aware of both the benefits and risks. Every year, many thousands of women undergo successful breast lift surgery. Fortunately, significant complications from a breast lift surgery are very rare, and patients are generally quite pleased with the results. Also, a Mastopexy generally does not interfere with the ability to breast feed if future pregnancies are anticipated.

Potential risks of breast lift include: bleeding; infection; and reactions to anesthesia. On rare occasion, there may be tissue loss and delayed wound healing along portions of the incision, especially in cases where the procedure has been extensive, or in smokers and diabetic patients. This may cause the scars to widen. A Mastopexy does leave permanent scars, although most of the necessary incisions are placed within natural skin folds, and all incisions are generally covered by a bra or bathing suit. The appearance of the scars can be expected to improve with time. Occasionally, scars may require revision at a subsequent procedure if they have healed poorly. Problems with the shape or position of the nipples or permanent loss of sensation or loss of tissue in the nipples, or breasts, may occur on rare occasion.

Most of the risks associated with a Mastopexy can be lessened and managed by selecting an expert in breast lift surgery. Carefully follow your cosmetic surgeons recommendations and instructions.

 Recovery

For the first 24 to 48 hours after surgery, your stitches will be covered with gauze and a soft wrap with a soft surgical bra will hold the bandages in place. Your breasts may be slightly bruised or swollen, and you may experience some mild discomfort for a couple of days. Pain medications are prescribed. Although seldom used, if drains are placed they are typically removed after 2 to 5 days. You may experience a temporary numbness in your nipples or breasts, which is generally caused by swelling during the initial post-operative period of six to twelve weeks. Normal sensation usually returns after three to six months. Permanent nipple sensation loss is extremely rare, however is a risk for any breast surgery.

Most patients may return to normal daily activities within 24 to 48 hours. You may resume non-strenuous work within one week or less following the surgery. You should avoid lifting heavy objects for 3-4 weeks. If implants were used, do not lift anything over 5 pounds for the first five days, anything over 10 pounds for the first 10 days, and anything over 15 pounds for the first 15 days. You may gradually resume strenuous physical exercise after approximately three to four weeks.

 Moving Forward

Breast Lift surgery is more complex than a straightforward breast augmentation. As with any cosmetic surgery procedure, it is critical that you choose the most qualified cosmetic surgeon with highest levels of training, experience.