This cosmetic operation, known as a mastopexy, is designed to lift and to fill empty breasts, particularly found after breastfeeding. The lift is directed to lifting the nipple, the focal point of the breast. Frequently improvement is requested either after having had children or after massive weight loss, but droop and upper breast emptiness can also occur in the young. Breasts of differing sizes, and breast reconstructions may also need to be equalised.
Many of the techniques used and refined for both augmentation and reduction surgery are used for breast lift surgery. As always, the eventual procedure chosen is that which is most appropriate to achieve the look you desire.
How do we cut?
The operation chosen depends on the initial size of the breast. Does the breast, and particularly the upper breast, need filling? If so, a Silicon implant alone or in combination with lift surgery may be needed. Is the breast too large? Reduction with a lift may do. Keep in mind that the drooping breast is often similar to an empty bag with too much skin. Tightening this skin and lifting the nipple without adding a Silicone implant will reduce the size of the breast. This may be a benefit, but if size must be maintained or increased, particularly in the upper breast, an implant will be required. As with breast augmentation, the implant may be placed behind your lifted breast only, or the upper part hidden behind your muscle.
A controversial alternative is the micro-injection of your own fat. This has both and converts and detractors. Supporters argue that your own tissues should be used whenever possible. The amount that can be injected, however, is definitely limited, and the long term durability not certain. I also have to harvest the fat which may be an advantage, but increases the duration and complexity of the operation.On the other hand, there is no cut needed.
This is offset by the expense of the BRAVA system which is a suction cup arrangement that must be faithfully worn each night for at least 6 weeks to keep the result from disappearing. Doubts have also been cast over future breast cancer surveillance.
Most of the operations to lift the nipple will at the very least leave a fine scar around the nipple. This is generally well hidden, but the higher the lift required, the more the scar extends down below the nipple until it eventually appears similar to a breast reduction scar with horizontal curved scar in the fold below the breast. Also remember to discuss the size of the nipple and surrounding darker skin known as the areola in relation to the new breast. This diameter may be increased or decreased, depending on breast size after operation, and on your preference.
As always, shape and size of the new breast may be offset by increased scarring. Vital to remember is that the initial droop is often a combination of loss of fullness and skin that will not tolerate stretch and therefore be able to rebound and shrink. This, in its most obvious form, shows as stretch marks. After the operation you still have the same skin. Too large an increase in size and therefore weight, or lack of supporting bra may lead to recurrence of the droop. The continued improvement to your breasts remains partly your responsibility.
What can go wrong?
As with most cosmetic surgeries, most unhappiness is due to expectations not being met. This, in general, is caused by a lack of adequate explanation before the operation by your Plastic Surgeon or misunderstanding by your surgeon as to your desires. It may also be an unrealistic expectation by you as to what is possible. Any size or symmetry revisions should ideally wait at least 6 months.
Adverse outcomes that require immediate attention include infections, loss of blood supply to the skin or nipple, large internal blood collection (haematoma) and any other unexplained surgical or anaesthetic problem. Bruising and swelling is inevitable, but a large, red, hot painful breast must be reported to the surgeon sooner rather than later. This is when your choice of a trusted surgeon becomes most apparent and telling, with logical explanations and reassurance as necessary or action if required. Remember that you will experience a change in the feeling in your nipples, normally with reduction in strength of nerve supply. This may be permanent, though it generally improves with time. This is inevitable, depending on how much the breast is lifted and reduced. Mostly, your feeling will return by 8 months but may be weaker than before.
There are many variations in stitch materials, cut patterns, whether to use drains or not, and types of bandages or dressings. These differences are generally less important than overall attention to detail and professional patient care.
Go to the consultation informed, as much information is available from the media and the internet. This will help the Doctor and ultimately help you get across the information as to exactly what your desires are. Ensure that you are clear on the possible complications and adverse outcomes. Any Doctor who denies any less than perfect results and complications is to be avoided. More important is honesty, and to find out how poor results will be managed and fixed. Word of mouth is often the most reliable information source. Ensure a good follow-up plan.
Remember that it is up to you to explain fully what you want. There are many variations in breast lift surgery. Stress what is important to you.
This surgery enhances breast shape and makes buying and filling a costume fun and easy. But nowhere in breast surgery is it as important to maintain your breast health and for this care to be complemented by a healthy lifestyle and weight management to ensure continued beautiful results.