Who is a candidate?
Breasts are a focal part of a women’s femininity and sexuality, and changes in breast size or shape can often affect a women’s self-esteem and confidence. Common reasons for having breast lift surgery (or mastopexy) include:
- Wanting to restore higher, tighter shape lost with age, pregnancy, and/or weight loss
- Correcting asymmetry between the breasts
There are 3 main incision types for a breast lift: circumareolar (around the border of the areola), lollipop (around the areola and a vertical incision from the areola to the fold), and full anchor (incision around the areola, vertical incision to fold, and incision along the breast fold).
The length of incisions needed really depends on the degree of lift needed. The circumareolar lift only provides about a 2 cm lift. Beyond that there is more puckering of the incision and flattening of the breast mound, with an ineffective lift. If there is more than a 2 cm lift needed, the next option is the lollipop incision, and beyond that is the full anchor (or Wise pattern) incision.
Risks of breast lift surgery
The standard surgical risks include pain; bleeding; infection; scarring; painful or hypertrophic scarring; injury to vessels, nerves, surrounding structures; change in nipple sensation; change in breastfeeding ability; asymmetry; poor cosmetic result; prolonged edema, numbness, parasthesias; fat necrosis; loss of all or part of nipple areola complex; need for further procedure and out of pocket costs; and risks of anesthesia.
Mammograms after breast lift
If you are age 40 or greater, have a family history of breast cancer, or have a lump, you should obtain a baseline mammogram prior to breast lift surgery. If you already get routine mammograms, it is recommended to wait 6 months after surgery to get your next mammogram in order to allow time for healing, and then resume your normal screening schedule.
Can I have a breast augmentation at the same time as the lift?
Yes, you can have a breast augmentation with implants at the same time as your breast lift. Some surgeons advocate having the lift first, and getting the implants at least 3 months later. It is possible, however, to combine the procedures, understanding that you may have to come back for a revision if needed later. In massive weight loss patients, there is also a greater tendency for the skin and tissues to stretch after the mastopexy, making the chance of revision higher. The second surgery is not always required, however one must always plan for the possibility, and understand this occurs at additional out-of-pocket costs. Please see the breast augmentation procedure for information on that portion of the procedure.
Postoperative follow-up visits
Visits following surgery typically occur the day after surgery (for dressing change and making sure there was no bleeding, fluid collection, or blood supply issues overnight), the week after surgery (for removal of drains if present), 2 weeks after that, and then spread out less frequently thereafter. The schedule is adjusted based on doctor/patient preferences and needs.
Walking the day of surgery is recommended. You may shower 24 hours after the drains have been removed. No baths, soaking in tubs, hot tubs, or swimming pools until incisions are fully healed. Gentle soap (non-perfumed, non-irritating soap preferred) and water over the incision is okay. Scar gel may be used starting 2 weeks after surgery or once incisions have no open areas, crusting, or scabs. A soft, supportive (snug but not too tight), non-underwire bra that zips or fastens in the front is recommended for the first 6 weeks following surgery. In general, Dr. Patel recommends avoiding exercise for 6 weeks following surgery, at which time you can ease back into your workouts. Light activity that does not involve the upper body may be okay around 3 weeks after surgery. You may return to work 1-2 weeks after surgery, depending on your pain level, stamina, and activities required in your occupation. You may drive once you are no longer taking pain medications or muscle relaxers, and allow a 24 hour minimum window between your last pain medication or muscle relaxant dose and driving. All recovery processes and recommendations vary patient to patient, so these general guidelines may not apply to every patient.