Breast Lift ( Mastopexy )
women who have developed sagging of their breasts. In some this occurs early in life, but more often it is related to ageing and frequently to pregnancy. Atrophy and thinning of breast tissue after pregnancy, combined with extra skin from stretching during pregnancy results in a smaller and sagging breast. Breast Lift is a procedure that removes excess skin, thereby lifting the breast and the nipple to a normal position. This procedure can be combined with Breast Augmentation / Enlargement.
The operation is done under general anesthetic and takes about 1.5 hours. It is day surgery, and you can go home about 2 hours after surgery is finished. During surgery Dr. Goldberg injects long acting local anesthetic in order to prevent sensitization of pain nerves, and to minimize discomfort after surgery. The usual incision is the “Lollipop” incision, which goes around the nipple, and then vertically down towards the fold under the breast. Through this incision the nipple is lifted to the new position, and the extra skin is removed. Absorbable stitches are used to close the incisions, and a compressive dressing is applied at the end of surgery.
The surgery will provide a lifted, more youthful breast which has a natural appearance. It requires minimal recovery, and causes minimal discomfort. Most patients require very little pain medication. The effects are long-lasting, and the effect on self-esteem is profound, both in and out of clothing. This procedure is often combined with others such as Breast Augmentation / Enlargement and Tummy Tuck (Abdominoplasty).
Dr. Goldberg prescribes several medications to ensure your comfort. These usually include Celecoxib and Percocet to control inflammation and pain, Ondansetron to prevent upset stomach, and Lorazepam (Ativan) to help with sleep if you need it. Swelling and bruising usually maximize around 3 days. You will need to wear something for support such as a sports bra continuously for 4 weeks, which can be removed for showers only. Most people are ready to return to work and light activities by 1 week after surgery. You will need to return for a check-up between 5 and 7 days after surgery. You need to avoid strenuous activity such as heavy lifting, work-outs, and sports for 4 weeks after surgery. Breast shape is not natural immediately after surgery. After 4 weeks it has largely settled, but ultimately the shape will continue to develop for about 6 months before the final shape is established.
There are general risks with Breast Lift such as bruising, bleeding, infection, and risks associated with general anesthetic. There are also some specific risks. The nipple is moved and left attached by a bridge of tissue to keep the blood supply, lactation ducts, and nerves for sensation. Sometimes this bridge isn’t adequate, and there can be a change in nipple sensation. Though most often temporary, this can be permanent. Approximately 50% of women are unable to breast feed for a variety of reasons. This risk does not change after Breast Reduction. Very rarely not enough blood is flowing to the nipple and part or even all of it may not survive, in which case it may need to be removed. This is exceedingly rare, and is more likely if you are a smoker. This surgery can correct asymmetry to a certain extent. However, some pre-existing asymmetry may persist. Also, it is possible that the surgery will result in minor asymmetry, though great care is taken to avoid this by doing precise planning and measurements before and during surgery. The scars usually heal well, and are minimally noticeable, but a small percentage of the population will develop thickened or keloid type scars. Because the skin is pulled together and “folded” at the base of the breast near the chest, there can be some minor puckering of the skin at this site. It may require as long as 6 months to diminish. In some people a small revision procedure under local anesthetic may be needed to remove some extra skin at this site. It is important for you to discuss these and other risks with Dr. Goldberg before proceeding with surgery.
The non-surgical alternative is to use a support bra. If the degree of sagging is mild to moderate and the patient is willing to consider breast implants, then Breast Augmentation / Enlargement is an excellent alternative, which has the benefit of both lifting the breasts and increasing size, while reducing the extent of the incisions and scar. Imagine a plastic bag partially filled with water; this is representative of a sagging breast. If the bag is filled with more water it then becomes tighter. The effect on a breast after an implant is inserted is similar. This is not effective for severely sagging breasts. In that case a Breast Lift or a combined Breast Lift and Breast Augmentation / Enlargement is required.
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