Procedure - Breast lift, or mastopexy, is a surgery that can restore the breasts to a more youthful, projecting shape and position. It is used to treat breast ptosis or “droopy” breasts. Breast ptosis is most frequently seen in patients who have lost a substantial amount of weight, women who breast fed their children, and is also a part of the normal aging process due to stretching of the ligaments that hold the breast high on the chest wall. Generally, the larger and more droopy (ptotic) the breast is, the more skin will have to be removed during the breast lift. Because of this, it is important to discuss with Dr. Brown the results you want and to carefully decide which of the various techniques (see below) he suggests will work best for you. A mastopexy can be combined with a breast augmentation in order to improve both the volume and the shape of the breasts.
Surgery and incisions – The surgery usually takes 1-2 hours to complete. If a breast augmentation is also performed an additional 60-90 minutes is required. The type of incisions Dr. Brown will make is determined by how droopy (ptotic) your breasts are. Minimally ptotic breasts often require only an incision around the circumference of the areola (the dark skin around your nipple). Moderately ptotic breasts require an incision around the areola plus a vertical incision down the center of the breast (also referred to as the “short scar” incision). Finally, to lift very ptotic breasts an additional horizontal incision along the lower breast crease is often required, resulting in an “anchor pattern” scar. Dr. Brown will make every effort to ensure that the scars are as inconspicuous as possible.
Note: A breast lift will not significantly change the size of your breasts or fill out the upper part of your breasts. There is a limit as to how high you can move the breast upon onto the chest wall with a breast lift alone. It is common that a breast implant will need to be placed to obtain a full upper breast when a breast lift alone can not accomplish this goal.
Initial consultation – In the initial conversation, Dr. Brown will begin by evaluating your health. If you smoke, you will be asked to quit for a minimum of 4 weeks prior to surgery as well as 4 weeks after surgery. Also, be sure to tell him if you’re taking any medications, vitamins, or other drugs. Also, be sure to tell Dr. Brown how your breasts have changed over time-both in terms of size and shape, and discuss any plans for future pregnancies, as pregnancy can affect the shape and size of your breasts. Dr. Brown will then explain which surgical technique is most appropriate for you, based on the shape and ptosis of your breasts, as well as your skin tone.
Preparing for surgery – Tell Dr. Brown about any medical problems you have, and any problems you may have had with surgery in the past. A history of bleeding problems, nausea with surgery and high blood pressure are all important to disclose to your surgeon, because these are risk factors for post-surgical bleeding. You will be told which medications to stop and which to take before surgery. If you smoke, you must quit smoking entirely for 4 weeks before and 4 weeks after surgery. If you get sick or have any health issues in the days before surgery, please notify the office at once in case we have to postpone your operation.
Can I go home the day of the surgery? – Yes, breast lifts can be done safely as an outpatient, and most patients will be able to go home the same day. Some patients may prefer to spend a night in the hospital if they have young children at home or live alone and do not have any help at home.
After Surgery Care
What about swelling and bruising? – Swelling and bruising are normal signs of the healing process. Swelling peaks at about 48 hours, and then rapidly decreases. By the end of the first few weeks, 50% of the swelling is gone. During this early period, your breasts will appear larger than their final size due to the swelling. By 6-8 weeks, a majority of the swelling has diminished. By six months, almost all the swelling is gone. Any remaining swelling is almost not perceptible.
What restrictions are there? – Generally, you can shower in 1-2 days after surgery, but you should not submerge incisions in the bath, hot-tub, or swimming pool for 2-3 weeks. The first day after surgery is usually spent lying in bed or sitting in a chair. Most patients then begin walking around the house the day after surgery. By the end of the first week, you will probably be ready to leave the house for short trips and light walks. Vigorous activities should not be performed until 6 weeks after surgery. Also, you shouldn’t do any heavy lifting (over 10 pounds) during these 6 weeks.
These are only general guidelines, and Dr. Brown will give you more specific instructions at your consultation.
When can I travel? – Traveling after surgery (air travel, long distance car trips, train rides, etc) should not be done before you have had your first postoperative visit. Typically, this occurs 5-7 days after surgery for suture removal. Patients who are at high risk for developing a blood clot should not travel until instructed by their surgeon. Short car trips under 60 minutes can be done before the first visit. A good rule of thumb is when you are off the stronger pain medication and can get up without assistance you are ready to go for a short drive. You should not drive the car yourself, until Dr. Brown gives you clearance for this.
What about mammograms? – Routine screening mammograms should be continued after breast augmentation for women who are 40 years of age and older. If you are under 40 but are receiving annual mammograms because you are at high risk for breast cancer you should also continue to have annual screenings. While there is no evidence that breast implants cause breast cancer, they may change the way mammography is performed. When you request a routine mammogram, be sure to go to a radiology center where technicians are experienced in the special techniques required to obtain a reliable x-ray of the breast tissue. Scientific studies have not shown a higher risk of developing breast cancer or a lower survival rate from breast cancer in women who have breast implants.
What if I have a problem? – When should I call the office? We always welcome calls from patients. If you have any concerns at any time, please feel free to contact our office. If it is an emergency, the answering service is available 24 hours a day, including weekends and holidays.