Breast Lift - Mastopexy

What is breast lift surgery?

A breast lift (mastopexy) is a surgical procedure that removes excess skin to raise and reshape sagging breasts. It can add volume to the breasts, which may have been lost due to ageing, weight change, genetics, pregnancy or breast-feeding. During breast lift surgery, the nipple and areola can be shifted to a higher, more youthful position.

Who is breast lift surgery for?

The best candidates for a breast lift are healthy, emotionally stable women who have realistic expectations about what breast lift surgery can achieve. It’s common for breasts to droop after pregnancy and breastfeeding, or after losing weight. Women who benefit the most from breast lift surgery are self-conscious about the shape of their breasts.

Breasts of any size can be lifted. If your breasts are small or have lost upper pole volume after pregnancy, breast implants inserted in conjunction with a breast lift can increase both your breast size and upper pole fullness.

Not every patient seeking a breast lift needs or wants breast implants, their need depends upon the specific goals and preoperative shape of the breast.

How is breast lift surgery performed?

There are a variety of different surgical techniques used for the reshaping and lifting of women's breasts. The three major types of breast lifts include:

• The donut, Benelli, or circumareolar breast lift. This technique accomplishes a lift by creating a donut-shaped incision around the areola. This technique offers mild correction to breast sagging. The amount of breast lift is limited.
• Lollipop or vertical breast lift. This technique involves incisions being made around the areola that extends downward. This breast lift option is used for moderate to severe sagging correction.
• The anchor breast lift. This technique begins with lollipop incisions, and then adds a horizontal incision along the breast crease. This technique is helpful in more extreme cases of breast sagging.

The breast lift operation is performed under a general anaesthetic and usually takes about 90 minutes. Breast lift surgery is usually an outpatient procedure. You’ll need someone to drive you home and monitor your recovery for the first one to two days after your operation.

You may also have injections of local anaesthetic to help with the pain after the operation. To reduce the risk of infection, you may be given antibiotics during the operation.

Your surgeon will usually insert drains (tubes) in the cuts to help your wounds to heal. They will usually close the cuts with dissolvable stitches. Your surgeon may wrap your breasts in bandages for support.

To increase breast size or upper pole fullness, some patients request breast augmentation with implants in addition to a breast lift. The main challenge in breast lift surgery is to produce a long lasting result with adequate filling of the upper part of the breast.

Patients with very loose skin and saggy breasts are often those with weak, easily stretched tissue – which is why they have the problem in the first place! So, despite the best efforts of the surgeon, the breast will, in some cases, sag again after surgery at least to some degree.

Virtually all saggy breasts can be improved with a lift, however a full, firm and youthful appearance may not be possible, and it is important for patients to have realistic expectations of what can actually be achieved in their particular case.

Patients who have lost a lot of weight present special challenges. If the breast skin has been overly stretched, two operations may be needed to produce the best possible result. This will be fully discussed during consultation with your Breast Surgeon.

Are there risks or complications with breast lift surgery?

Any surgical operation brings complications of anaesthesia. Your anaesthetist will be able to discuss with you the possible complications of having an anaesthetic.

General complications of every surgery include:

• Pain. Your healthcare team will give you medication to control the pain. To reduce discomfort and prevent headaches, it’s important that you take the medication.
• Blood clot in your leg (deep-vein thrombosis – DVT). This can cause pain, swelling or redness in your leg, or the veins near the surface of your leg to appear larger than normal. Your healthcare team will assess your risk. They will encourage you to get out of bed soon after the operation and may give you injections, medication, or special stockings to wear. Let the healthcare team know straightaway if you think you might have a DVT.
• Blood clot in your lung (pulmonary embolus). If a blood clot moves through your bloodstream to your lungs. If you become short of breath, feel pain in your chest or upper back, or if you cough up blood, let the healthcare team know straightaway. If you are at home, call an ambulance or go immediately to your nearest Emergency department.

What are the specific risks and complications of breast lift surgery?

• A reduced ability to breastfeed: This will happen if the milk ducts in your breast are damaged or removed, your nipple sensation has been affected or your nipple has been lost.
• Asymmetry: Most women’s breasts are not identical, with size and shape differences. Breast asymmetries may also occur after surgery including breast size, shape, and nipple position, and the shape and sizes of the nipples themselves. Following the initial breast lift procedure, additional surgery may be necessary to revise residual asymmetry.
• Breast disease: It is recommended that all women perform regular self-examination of their breasts and have breast screening such as mammograms or ultrasounds dependent upon your age, risk profile and need. Your surgeon may request you have a pre-operative mammogram prior to proceeding with your surgery. If you are over 40, or under 40 but with a family history of breast cancer a mammogram before surgery is recommended. Breast tissue removed during a procedure is routinely sent for examination and you will be notified of in the event of suspicious tissue being detected for further follow up. Breast lift surgery will cause internal scarring which may make it difficult to interpret mammograms for up to 2 years.
• Breast-feeding: Having breast lift surgery is unlikely to reduce your ability to breast-feed. This is not universal and is unpredictable. It’s important to note that many women (up to 20%) are unable to breast feed even without having breast lift surgery.
• Change of breast and nipple sensation: This usually settles within 12 months, but the change in sensation may be permanent. You will lose nipple sensation permanently if your surgeon had to detach your nipple and areola during the operation.
  Developing a lump (fat necrosis): It is usual to get lumps in your breast caused by minor damage to areas of fat during the operation. These areas can become hard and swollen. Although they tend to shrink over the next few months, sometimes they turn into scar tissue and the lump will be permanent. You’ll need to learn to recognise what this kind of lump feels like so you don’t confuse it with a breast cancer.
• Loss of skin: During the breast lift operation, the blood supply in your breast can get damaged. This can cause some areas of skin to die, including the nipple areola. The risk of this will be higher if you smoke, are overweight, have very large or very droopy breasts, or have other medical problems such as diabetes.
• Mastitis and infection: Infection after breast lift surgery occurs but is uncommon. Occasionally, temporary mastitis can occur. This is very uncommon and is not usually serious. If you’ve had breast implants during the breast lift surgery, mastitis and infection can be serious as the implant may get infected. If the breast implant gets infected, it will need to be removed for up to 6 months.
• Numbness or continued pain: This can be on the outer part of your breast caused by injury to the small nerves that supply your skin. Any pain or numbness usually gets better within a few weeks but can sometimes continue for many months.
  Scars: After breast lift surgery you will have scars on your breast. Your Breast Surgeon will demonstrate the approximate position of these to you. Normally, a breast lift scar pattern is either a vertical (lollipop) pattern, or an inverted T (anchor) pattern. The decision depends upon which will result in the best postop shape, and will best meet your goals of surgery. Scars generally fade over time but won’t disappear. It’s normal for scars to take up to 2 years to fully mature.
• Skin contours and irregularities: Visible wrinkling and depressions in the skin may occur. Contour and shape irregularities may also occur. Residual skin irregularities at the ends of the incisions known as “dog ears” and skin pleating are common. While they usually improve over time, they can be surgically corrected at a later stage. This correction is usually done under a local anaesthetic.
• Stiff shoulder: Your healthcare team will give you exercises to keep your shoulder moving and it’s important you do them. If you need to relieve pain, take the painkillers you’ve been prescribed.
  Swelling: One in 20 may develop a swelling inside the breast caused by blood or fluid collecting. If you experience this, you may need another operation to remove the blood or fluid.
• Wound healing: Minor wound healing delays are not uncommon with Breast Lift surgery. Generally dressings are sufficient to assist with this healing, and the final result is not usually affected. Wound separation after surgery is uncommon in breast lift surgery. Should this occur, additional treatment including further surgery may be required.

What you can do to help make the breast lift surgery a success

Let your doctor know about all the medication you take and follow their advice. This includes all blood-thinning medication as well as herbal and complementary remedies, dietary supplements, and medication you can buy over the counter.

If you smoke, stopping smoking several weeks or more before the breast lift operation may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight before your breast lift operation. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

You can reduce your risk of infection in a surgical wound during the breast lift operation if:

• In the week before the operation, you don’t shave or wax the area where an incision will be made.
• You have a bath or shower either the day before or on the day of the operation.
• You keep warm around the time of the operation. Let the healthcare team know if you feel cold.

Post surgery breast lift care

Breast lift surgery is usually day surgery or an overnight stay. After your breast lift surgery, you’ll be given medication to limit any pain and nausea. Usually there will not be drain tubes but sometimes they’re used to remove excess fluid from the wound. Drain tubes will be removed once the seepage ceases, usually within a few hours. An intravenous drip will be removed once you can take fluids by mouth.

At home, you should rest and take your medication for pain as directed. Heavy lifting and strenuous exercise should be avoided for up to six weeks, but you should walk daily. A light pressure bra or sports bra gives support in the first few weeks after surgery.

One to two weeks off work is usually sufficient depending on the occupation. Driving can be resumed once you are comfortable, can react quickly if necessary, and are not taking strong painkillers. This normally takes around five to seven days.

What happens if need revisional breast lift surgery?

If your breast lift surgery has not been successful, you may need revisional surgery. It’s important to note that rehabilitating droopy breasts can be quite complex. Despite careful planning and expert surgery this can occur but can be corrected. Usually, an anaesthetic is needed, with a day surgery admission.

If the breast tissue and skin is loose, and after lifting some degree of relaxation, slight residual drooping of the surgical result is common. Where implants are used, the position of the lifted breast over the implant can be hard to predict with complete accuracy. This is because women have different elasticity of their breast tissue.

Life after breast lift surgery

After breast lift surgery, it will take around four months for the breast to settle into its new form. It will take at least a year for the scars to fade. Though most scars will fade significantly, patients who have the genetic predisposition to heal with poor scars may have readily visible scars for life.

Over time, if your body shape changes significantly or you have pregnancies; there may be a need for a further breast lift. If you lose a large amount of weight, the breasts will drop. Most women who have had a breast lift can still produce breast milk after pregnancy.

Alternatives to breast implant surgery

If you are unsure about having breast augmentation surgery, there are alternatives. Using padded bras or inserts can make your breasts appear to have a better shape.

If you don’t have much excess skin and your breasts aren’t droopy, your Breast Surgeon may be able to assess you for a breast augmentation. This involves using silicone breast implants to make your breasts larger with breast augmentation.

If you have a large bust size, your surgeon may be able to assess you for a breast reduction. This involves removing some breast tissue, excess fat and skin to improve the shape of your breasts.

To find out if breast lift surgery is right for you consult a Breast Surgeon

Breast uplift is a cosmetic operation to improve the shape of your breast. You should consider the options carefully and have realistic expectations about the results.

Breast lift surgery is usually safe and effective but complications can happen. You need to know about them to help you to make an informed decision about surgery. Knowing about them will also help to detect and treat any problems early.

Your Breast Surgeon will carry out a detailed assessment before deciding if breast lift surgery is suitable for you. This may include taking photos for your medical records. They’ll also examine your breasts and ask you questions about your medical history. Your surgeon will also ask you if you are planning to lose a lot of weight. It may be better to lose the weight first before having surgery.
Let your Breast Surgeon know if you are pregnant or planning to become pregnant in the future. Pregnancy can change the size and shape of your breasts and may affect the long-term results of surgery.

Find the best Australian Breast Lift Surgeons here.

Key facts

• Breast lift surgery (mastopexy) will leave permanent, noticeable scars on your breasts. These scars are usually around the nipple, vertically down to the fold underneath the breast.

• Having breast lift surgery will not decrease your breast size. Without implants, you will have the same size bra as before the procedure. If you have breast implants, your bra size will be larger.

• Breast lift surgery can reduce the size of the areola, the darker skin around the nipple.

• Most women who have successful breast uplift surgery are more comfortable with their appearance, are able to wear more revealing clothing and report that their personal and sexual relationships improve.

• Your breast will always drops for 2–3 months after surgery, as the swelling reduces. The breast shape then stabilizes and the final result is seen.

• Realistic expectations about breast lift surgery are important. It’s important to express your desired outcome to the Breast Surgeon. Breast lift surgery without implants will lift your breasts well, but won’t increase the upper breast pole fullness. Being realistic about your own anatomy and situation is essential to achieving satisfaction with your breast lift outcome. Not all patients can achieve the exact breast enhancement result they most desire.

Important to know

So you can make an informed decision, your elected surgeon will discuss the possible risks associated with a breast lift. Although the majority of patients do not experience these complications, it's important to understand how they can be managed in the event that they occur.