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Breast liftBy Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/breast-lift/MY02076
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A breast lift — also known as mastopexy — is a surgical procedure to change the shape of your breasts. During a breast lift, excess skin is removed and breast tissue is reshaped to restore firmness and raise the breasts to a higher position.
You might choose to have a breast lift if your breasts sag or your nipples point downward. A breast lift might also boost your self-image and self-confidence.
A breast lift won't significantly change the size of your breasts. However, a breast lift can be done in combination with breast augmentation or breast reduction.
Why it's done
As you get older, your breasts change — losing elasticity and firmness. There are many causes for these kinds of breast changes, including:
- Pregnancy. During pregnancy, the ligaments that support your breasts might stretch as your breasts get fuller and heavier. This stretching might contribute to sagging breasts after pregnancy — whether or not you breast-feed your baby.
- Weight fluctuations. Changes in your weight can cause your breast skin to stretch and lose elasticity.
- Gravity. Over time, gravity causes ligaments in the breasts to stretch and sag.
A breast lift can reduce sagging and raise the position of the nipples and the darker area surrounding the nipples (areolae). The size of the areolae can also be reduced during the procedure to keep them in proportion to the newly shaped breasts.
You might consider a breast lift if:
- Your breasts sag — they've lost shape and volume, or they've gotten flatter and longer
- Your nipples — when your breasts are unsupported — fall below your breast creases
- Your nipples and areolae point downward
- Your areolae have stretched out of proportion to your breasts
- One of your breasts falls lower than the other
A breast lift isn't for everyone. If you're considering pregnancy at any point in the future, you might delay getting a breast lift. During pregnancy your breasts could stretch and offset the results of the lift.
Breast-feeding is a consideration as well. Although breast-feeding is usually possible after a breast lift — since the nipples aren't separated from the underlying breast tissue — some women might have difficulties producing enough milk.
While a breast lift can be done on breasts of any size, women with smaller sagging breasts will likely have longer lasting results. Larger breasts are heavier, which makes them more likely to sag again.
A breast lift poses various risks, including:
- Scarring. While scars are permanent, they'll soften and fade within one to two years. Scars from a breast lift can usually be hidden by bras and bathing suits. Rarely, poor healing can cause scars to become thick and wide.
- Changes in nipple or breast sensation. While sensation typically returns within several weeks, some loss of feeling might be permanent. Erotic sensation typically isn't affected.
- Irregularities or asymmetry in the shape and size of the breasts. This could occur as a result of changes during the healing process. Also, surgery might not successfully correct pre-existing asymmetry.
- Partial or total loss of the nipples or areolae. Rarely, the blood supply to the nipple or areola is interrupted during a breast lift. This can damage breast tissue in the area and lead to the partial or total loss of the nipple or areola.
- Difficulty breast-feeding. While breast-feeding is usually possible after a breast lift, some women might have difficulties producing enough milk.
Like any major surgery, a breast lift poses a risk of bleeding, infection and an adverse reaction to anesthesia. It's also possible to have an allergic reaction to the surgical tape or other materials used during or after the procedure.
How you prepare
Initially, you'll talk to a plastic surgeon about a breast lift. During your first visit, your plastic surgeon will likely:
- Review your medical history. Be prepared to answer questions about current and past medical conditions. Tell the doctor if you have a family history of breast cancer. Share the results of any mammograms or breast biopsies. Talk about any medications you're taking or have taken recently, as well as any surgeries you've had.
- Do a physical exam. To determine your treatment options, the doctor will examine your breasts — including the placement of your nipples and areolae. He or she will also consider the quality of your skin tone. Breast skin that has good tone will hold the breasts in a better position after a breast lift. The doctor might also take pictures of your breasts for your medical record.
- Discuss your expectations. Explain why you want a breast lift and what you're hoping for in terms of appearance after the procedure. Make sure you understand the risks and benefits, including scarring and changes in nipple or breast sensation.
Before a breast lift you might also need to:
- Schedule a mammogram. Your doctor might recommend a baseline mammogram before the procedure and another mammogram a few months afterward. This will help your medical team see changes in your breast tissue and interpret future mammograms.
- Stop smoking. Smoking decreases blood flow in the skin and can slow the healing process. If you smoke, your doctor will recommend that you stop smoking before surgery and during recovery.
- Avoid certain medications. You'll likely need to avoid taking aspirin, anti-inflammatory drugs and herbal supplements, which can increase bleeding.
- Arrange for help during recovery. Make plans for someone to drive you home after surgery and stay with you as you begin to recover. You might need someone to help you with daily activities, such as washing your hair, during your initial recovery.
What you can expect
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A breast lift can be done in a hospital or an outpatient surgical facility. Sometimes the procedure is done with sedation and local anesthesia, which numbs only part of your body. In other cases, general anesthesia — which renders you unconscious — is recommended.
During the procedure
Techniques used to remove breast skin and reshape breast tissue vary. The specific technique your plastic surgeon chooses will determine the location of the incisions and the resulting scars.
Your doctor might make incisions:
- Around the areolae — the darker area surrounding the nipples
- Extending downward from the areolae to the breast creases
- Horizontally along the breast creases
Your doctor might place stitches deep within your breasts to reshape your breast tissue and, if necessary, reduce the size of your areolae. He or she will remove excess breast skin and shift the nipples to higher positions. Then your doctor will bring together the breast skin and close the incisions with stitches, surgical tape or skin adhesives.
The procedure typically takes two to three hours.
After the procedure
After a breast lift, your breasts will likely be covered with gauze and a surgical support bra. Small tubes might be placed at the incision sites in your breasts to drain any excess blood or fluid.
Your breasts will be swollen and bruised for about two weeks. You'll likely feel pain and soreness around the incisions, which will be red or pink for a few months. Numbness in your nipples, areolae and breast skin might last for about six weeks.
In the first few days after a breast lift, take pain medication as recommended by your doctor. Avoid straining, bending and lifting. Sleep on your back or your side to keep pressure off your breasts.
Avoid sexual activity for at least one to two weeks after the breast lift. Ask your doctor when it's OK to resume daily activities, such as washing your hair, showering or bathing.
Drainage tubes placed near your incisions are typically removed within a few days. When your doctor removes the tubes, he or she will also probably change or remove your bandages.
Talk to your doctor about when — or if — your stitches will be removed. Some stitches dissolve on their own. Others must be removed in the doctor's office, often one to two weeks after the procedure.
Continue to wear the surgical support bra around the clock for three or four days. Then you'll wear a soft support bra for three or four weeks. Your doctor might suggest using silicone tape or gel on your incisions to promote healing.
While you're healing, keep your breasts out of the sun. Afterward, be careful to protect your incisions during sun exposure.
You'll notice an immediate change in the appearance of your breasts — although their shape will continue to change and settle over the next few months.
Initially, scars will appear red and lumpy. While scars are permanent, they'll soften and become thin and white within one to two years. Scars from a breast lift can usually be hidden by bras and bathing suits.
You might notice that your bra size is a little smaller after a breast lift — even if you haven't had a breast reduction in combination with the procedure. This is simply a result of your breasts becoming firmer and rounder.
Keep in mind that breast lift results might not be permanent. As you age, your skin will naturally become less elastic and some sagging might occur — especially if you have larger, heavier breasts. Maintaining a stable, healthy weight can help you retain your results.
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