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Over the years, factors such as pregnancy, nursing, and the force of gravity take their toll on a woman's breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. Breastlift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts. Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. If your breasts are small or have lost volume--for example, after pregnancy--breast implants inserted in conjunction with mastopexy can increase both their firmness and their size. The Best Candidates for Breast Lift The best candidates for mastopexy are healthy, emotionally-stable women who are realistic about what the surgery can accomplish. The best results are usually achieved in women with small, sagging breasts. Many women seek mastopexy because pregnancy and nursing have left them with stretched skin and less volume in their breasts. However, if you're planning to have more children, it may be a good idea to postpone your breast lift. While there are no special risks that affect future pregnancies (for example, mastopexy usually doesn't interfere with breast-feeding), pregnancy is likely to stretch your breasts again and offset the results of the procedure. Mastopexy does leave noticeable, permanent scars, although they'll be covered by your bra or bathing suit. Breast Lift Surgery In your initial consultation, it's important to discuss your expectations frankly with Dr. Bolitho, and to listen to his opinion. Every patient--and every physician, as well--has a different view of what is a desirable size and shape for breasts. Dr. Bolitho will discuss the variables that may affect the breast lift procedure--such as your age, the size and shape of your breasts, and the condition of your skin--and whether an implant is advisable. For many patients with only a slight drooping of the breasts an implant alone may correct both the loss of volume and serve to lift the breast, thus avoiding the need for further incisions. In more severe cases, the nipple and areola will need to be repositioned during the procedure, and this will mean at least an incision around the areola. Depending on your age and family history, you may require a mammogram before breast lift surgery. You'll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. You will also receive your prescriptions for after your breast lift surgery. While you're making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed. Breast lifts are usually performed under general anesthesia, which means you'll sleep through the operation. In selected patients--particularly when a smaller incision is being made--Dr. Bolitho may use local anesthesia, combined with a sedative to make you drowsy. You'll be awake but relaxed, and will feel minimal discomfort. Mastopexy usually takes one and a half to three hours. Dr. Bolitho prefers to use a short-scar technique, with the incision either around the areola only, or an incision around the areola and extending down the front of the breast in the shape of a lollipop. During the surgery, the nipple and areola are moved to the higher position. The skin surrounding the areola is then brought down and together to reshape the breast. If you're having an implant inserted along with your breast lift, it will be placed in a pocket directly under the breast tissue, or deeper, under the muscle of the chest wall. After Surgery After surgery, you'll wear an elastic bandage or a surgical bra over gauze dressings. Your breasts will be bruised, swollen, and uncomfortable for a day or two, but the pain shouldn't be severe. Any discomfort you do feel can be relieved with medications prescribed by your surgeon. Within a few days, the bandages or surgical bra will be replaced by a soft support bra. You'll need to wear this bra around the clock for three to four weeks, over a layer of gauze. The stitches will be removed after a week or two. If your breast skin is very dry following surgery, you can apply a moisturizer several times a day. Be careful not to tug at your skin in the process, and keep the moisturizer away from the suture areas. You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This numbness usually fades as the swelling subsides over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent. Healing is a gradual process. Although you may be up and about in a day or two, don't plan on returning to work for a week or so, depending on how you feel. And avoid lifting anything over your head for four weeks. If you become pregnant, the operation should not affect your ability to breast-feed, since your milk ducts and nipples will be left intact. Potential Risks & Side Effects As with any surgery, there is always a possibility of complications or a reaction to the anesthesia. Bleeding and infection following a breast lift are uncommon, but they can cause scars to widen. You can reduce your risks by closely following Dr. Bolitho's advice both before and after surgery. Mastopexy does leave noticeable, permanent scars, although they'll be covered by your bra or bathing suit. (Poor healing and wider scars are more common in smokers.)
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