Details of Breast Lift (Mastopexy) Procedures
Consultation
Patients seeking breast lift surgery are satisfied with the size of their breasts but want to improve their shape. Common reasons for change in breast shape include age-related sagging, and postpartum or post-breastfeeding changes. A breast lift improves the overall shape of the breast and returns the nipple to a higher position. For diagrams showing breast lift surgery on the website of the Canadian Society of Plastic Surgeons please click here.
There are three common types of mastopexy procedure:
Periareolar:
The “periareolar” or “donut” mastopexy involves removing a donut-shaped, circular strip of excess skin from around the edge of the areola. The scar is less visible because it around the border of the areola, which is pigmented. Although this causes the least scarring of the three types of mastopexy described here, relatively little skin is removed so in general less tightening is achieved with this type of breast lift.
Vertical:
The “vertical” mastopexy removes skin from around the areola and from the lower part of the breast below the areola. It results in a scar around the nipple and down the midline part of the lower breast, which resembles a “lollipop”.
Inverted T:
The “inverted-T” mastopexy in a scar around the nipple, down the front of the breast, and in the breast crease. This procedure removes the most skin from the breast but it also causes the most scarring so it is used for patients with severe sagging; for example, after massive weight loss.
Preoperative Preparation
Prior to any surgical procedure, a general physical examination by a family physician is recommended. Dr. Andrade is pleased to send a consultation letter to the family physician if the patient wishes to keep them informed of their operation.
Routine preoperative blood tests and other tests usually need to be arranged prior to surgery. It is very important to inform Dr. Andrade about all medications, vitamins, and herbal supplements. Some of these substances can increase the risk of bleeding and must be stopped prior to surgery. Do not have anything to after midnight the evening before surgery. Water (no other liquids) may be consumed up to 4 hours before surgery. Bring a sports bra without an underwire, with clips in the front or back (not needing to be pulled over your head). Dr. Andrade and a registered nurse will review all of these details prior to the operation.
Day of Surgery
Breast lift surgery is performed under a general anesthetic, either in Dr. Andrade’s private facility in Newmarket, or at Southlake Regional Health Centre. The anesthetic is delivered by a board-certified Anaesthesiologist. The operation takes less than 2 hours but total time spent in the facility is approximately 4-5 hours.
Postoperative Recovery
Patients are given a prescription for an analgesic (pain reliever) and antibiotic. Most patients are doing their own self-care and other their light activities the day after surgery, but Dr. Andrade recommends patients avoid heavy lifting or vigorous excercise involving the chest muscles for 4-6 weeks following surgery. Showering is permitted 48 hours postoperatively. Tapes (Steri-Strips) are glued to the skin and seal off the wound. They usually remain adherent for at least 10-14 days, after which time they may be removed. A scar reduction program will be prescribed by Dr. Andrade.
Immediately following mastopexy surgery, the breasts may be bruised, swollen, and tender, and the shape may appear unusual. Most of these symptoms resolve within a few weeks. The breast shape will continue to improve over 3-6 months, and scars generally soften and fade significantly by 6-12 months postoperatively.
Benefits and Risks of Surgery
The majority of patients are satisfied with the shape of their breasts following breast lift surgery, and the results usually last for many years. However, age-related changes to the breasts will continue to occur over time. Some patients may seek additional surgery in the future to improve the appearance of their breasts. Immediately after surgery, all patients will have some degree of breast pain, swelling, and bruising.
Uncommon problems immediately following breast lift surgery include but are not limited to bleeding, infection, wound healing problems, chronic pain, changes in breast or nipple sensation, or loss (necrosis) of the areola. Long-term problems can result such as asymmetry, puckering or irregularities of the breast or nipple area, or prominent scars. Rarely, life-threatening complications can arise during or after any operation. Dr. Andrade will discuss other specific risks and answer any questions during the consultation.
Common Questions About Breast Lift (Mastopexy) Procedures
Will I still need to wear a bra following breast lift surgery?
Although breast lift surgery elevates and tightens the breast, Dr. Andrade recommends that patients continue to wear a bra, particularly while playing sports or doing other vigorous activities. This will provide added support and help to maintain the longterm shape of the breast.
Will my scars be visible?
Scars usually soften and fade significantly within 2-3 months following surgery and they continue to mature for about 1 year. It is important to avoid tanning beds or suntanning while scars are immature, because they can become pigmented. Scar massage and certain topical gels and other treatments can help scars to mature and fade. Even if meticulous surgical technique is used and there are no immediate postoperative healing problems, the final appearance of scars is largely dependent upon each patient’s unique healing response. Some patients heal with fine, faint scars while others have more visible scars. Very prominent raised or symptomatic scars, called “hypertrophic scars” or “keloids”, are uncommon after breast surgery.
Will my breast size be different after surgery?
The breast lift procedure involves removing excess breast skin but usually all of the underlying glandular tissue is preserved (unless the patient specifically requests to have smaller breasts). Therefore the overall amount of breast tissue present before and after surgery is nearly the same. However, a different bra size or type may be required postoperatively because of the new breast shape.
