Mastopexy (Breast Lift, with or without Implants)

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Breast Lift Explained - Australian Cosmetic Surgery Magazine (ACSM)

Dr Kourosh Tavakoli explains how A breast lift corrects drooping breasts and improves their shape and position.

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What is a Breast lift / Mastopexy?

Breast lift or Mastopexy is designed to improve the shape and position of the breasts without reducing their size. It is a term used for breasts which sag but are not necessarily too large. Sagging of the breasts may occur with normal development for some women or as part of aging. Pregnancy, breast-feeding, and weight loss are other conditions which increase breast ptosis (sagging). Some patients will have a better shape to their breast if an implant is used at the time of mastopexy.

Please understand that mastopexy can not be performed without some degree of scarring. The scars usually heal well but in some cases they can persist for a few years.

“...Breast Lift or mastopexy with or without implant, is considered by most experts in the field of cosmetic surgery to be one of the most difficult breast operations...” Dr K Tavakoli, FRACS

Few would disagree with the statement that women’s breasts symbolize her most feminine physical characteristic. Aesthetic plastic surgery of the breast is a compilation of procedures that range from simple breast augmentation to more complexbreast lifting. Breast lifting can be done alone or combined with a breast implant. In fact breast reduction is a form of breast lifting associated with removing breast tissue.

It is becoming increasingly obvious to the savvy plastic surgeon given the spectrum of breast shapes and conditions that simply using breast implants alone will not always produce aesthetically acceptable results. In assessing breast geometry and design, the plastic surgeon must consider 3 crucial parameters:

1. Breast Volume & Shape,
2. Skin condition,
3. Nipple position

Although augmenting breasts can to some extent rectify the volumetric problem in an otherwise perfectly shaped breasts, the issues relating to nipple position and excessive skin envelope cannot be addressed.

Breast ptosis (pronounced "toe-sis") or droopiness is a condition that affects women of all ages. Although we tend to associate breast ptosis with old age, young girls after significant weight loss or post-breast-feeding are often faced with varying degrees of droopiness. For these women wearing supportive bra is essential in order to disguise their saggy breasts.

Breast ptosis can be classified according to the position of the breast and nipple in relation to breast fold:

1. Grade 1: Breast is below fold, Nipple-areola at fold
2. Grade 2: Breast is below fold, Nipple-areola is also below fold
3. Grade 3: Nipple-areola pointing to the floor

lolly-pop Vertical Mastopexy scar

Breast lift surgery is therefore designed to return breast shape to a more youthful appearance in 3 ways:

1. Move the position of nipple-areola complex,
2. Remove excess breast skin,
3. Reshape the breast tissue

Although mastopexy does not change the amount of breast tissue a woman has, it can change the shape dramatically. This in turn can affect the overall breast size and projection. However, there are many cases where breast lifting needs to be combined with a breast implant to produce a desirable breast size. The combined breast lift-augmentation is considered one of the more difficult operations in plastic surgery. It can be performed in either one stage or more commonly in two stages.

Modern plastic surgery is about creating minimal scar in return for achieving the most desirable aesthetic outcome. The prospective patient should be aware of this delicate balance prior to embarking on this procedure.

The breast lift surgery is basically performed using 4 types of incisions or scars:

2 Types of Nipple re-positioning procedures with little effect on the breast shape but effective in aligning nipple-areolar complex:

1. Cresenteric scar (half-moon) Lift
2. Donut-shaped scar (periareolar) around the nipple-areola complex (Benelli-Goes)

2 Types of Breast Lift procedures that can re-shape the breast and modify the nipple-areolar position for moderate to severe droopyness (ptosis):

1. Lolly-pop scar from the areola to the breast crease (LeJour-Hammond)
2. Traditional anchor-shaped scar, inverted T-scar (Wise pattern)

Further to the skin scarring pattern, breast tissue must be surgically contoured from an elongated shape into a more youthful conical structure. This maneuver is an integral part of breast remodeling process.

The Breast Lift Procedure

Patients must stop smoking for at least 2 months before and after the operation. Time off work from this procedure is usually 10-14 days for recovery and healing to take place. Smoking increases chances of bleeding, infection and long term scarring.

What happens to the circulation and sensation of my nipple?
Generally, the nipple-areolar complex (brown part of the breast) is carried on some breast tissue to keep it alive. This usually preserves the nipple sensation and keeps it viable.

How long is the patient hospitalized?
A Mastopexy can be done as an outpatient procedure requiring no hospitalization. Usually suction drains (plastic tubes) are left in place after a Mastopexy. PAtients will be given instructions how to empty drains. Drains usualy stay in 1-3 days.

What kind of anaesthesia is used?
A general anaesthetic is used on all Mastopexies.

Who is on the surgical team?
Dr Tavakoli will always perform the operation.

What can I expect postoperatively?
Discomfort, swelling, and discolouration of the breasts are to be expected for several weeks. Usually, our patients return to almost normal activity within 10 days. The scars at the incision lines typically become reddish, raised, and firm a few weeks after surgery, but after many months become pale and soft. After 12-24 months, the scars are relatively inconspicuous. The nipples and some areas of the skin may be numb or sensitive after surgery. Sensation frequently returns within a few weeks or months but may be diminished or overly sensitive.

Will the breasts start to sag again?
Gravity continues to have its effect, and there is a tendency for the skin of the breast to stretch over a long period of time. Women vary a great deal in this respect. In general, the smaller the breasts, the less tendency for sagging to recur. If the breasts sag further, minor revisions may be needed to reverse the process. If Dr Tavakoli tries to lift heavy breasts without making them smaller at the same time, sagging will return much sooner. One key point to a satisfying result is having realistic expectations.

What are my limitations in activity post-operatively?
You should plan to avoid activities, which require much raising of the arms above the level of the head for 10 days after surgery. With great care, you can drive about 7 days after surgery. Patients can usually return to work in a few days unless their occupation requires particularly strenuous movements and lifting. In such cases, 2-3 weeks should be allowed.

1. Walking can commence within 7 days,
2. Light jogging within 4 weeks,
3. Gym & Pilates after 4 weeks and upper body weights 9 weeks.

Surgical risks may include: infection, bleeding, asymmetry, keloid scarring, and nerve damage. Damage to the blood supply of the nipple-areolar complex, although uncommon, can occur.

• For Benelli (Around Nipple scar) Mastopexy or Breast Lift with Implant Photos, Please Click Here
• Le Jour ("lollypop" scar) & Anchor (inverted-T scar) Mastopexy or Breast Lift with Implant, Please Click Here
• For Le Jour (vertical "lollypop" scar) Mastopexy or Breast Lift without Implant, Please Click Here