Breast Lift (Mastopexy)
Overview:
In the U.S., along with breast augmentation (enlargement) and breast reduction, breast lifts account for a sizeable percentage of cosmetic surgery procedures performed each year. In the case of breast lift procedures, there are a number of reasons why this surgery is sought. Significant weight loss, pregnancy and subsequent breast feeding are factors that can contribute to the development of sagging, drooping breasts.
Those women who are satisfied with the size of their breasts, but wish to address drooping or sagging of pendulous breasts may be good candidates for breast lift surgery. In most cases, the issue is a lack of breast firmness or fullness.
The most common breast lift patient is the woman who has had two or more children and has breast-fed. Of course, breast-feeding is considered important for the baby and the cosmetic appearance of the breast should be secondary to that aspect of child-raising. Fortunately, cosmetic issues can be addressed, afterwards, by way of a mastopexy procedure.
Benefits:
The benefits of a mastopexy are mostly cosmetic and can relate to self esteem. However, there are certain medical benefits associated with the procedure. Drooping, pendulous breasts can sometimes be directly related to back and neck pain due to weight of the breasts and their relationship to the posture of the patient.
After breast lift surgery, the patient will notice an immediate change in the contour and shape of the breasts. In some cases, a mastopexy can be performed in conjunction with a breast reduction or a breast enlargement in order to shape the breasts at the same time that breast size is being altered. This provides more enhanced cosmetic results than a single procedure would provide.
Types of Breast Lift Procedures:
There are two major types of breast lift surgery: Concentric Mastopexy and Anchor Shaped Mastopexy.
Concentric Mastopexy:
This procedure is also known as “doughnut mastopexy” because of the concentric circular shape of the incisions made around the areola. This procedure is usually indicated for women who possess smaller breasts without severe drooping. This procedure involves fewer incisions and can, in some instances, be performed without general anesthesia and a local anesthesia is used in conjunction with a sedative.
Anchor Shaped Mastopexy:
This procedure is indicated for women with larger breasts that exhibit a greater degree of drooping. In this case, an anchor-shaped incision is made in order to remove excess breast skin and tissue. For this procedure, general anesthesia is used.
Patient Characteristics:
The ideal patient characteristics involve individuals who have realistic expectations regarding the outcome of the breast lift surgery. This should be discussed with your cosmetic surgeon during an initial interview. Obviously, the specifics regarding the final shape and contours of the breasts should be carefully considered before your decision is made and, even then, there may be slight variations to the expected outcome.
In order to make a well informed decision, you should also view multiple before and after photos and discuss various treatment options available. Patients should be in good shape, physically, and have a well-adjusted view of their body image.
Procedures:
Your surgeon will provide you with a list of instructions that should be followed prior to your surgery. These instructions will outline restrictions regarding eating, drinking, smoking and medications/vitamins. There will also be specifics regarding weight loss prior to the surgery.
Concentric Mastopexy:
This procedure begins with concentric circles being drawn around the areola before incisions are made. Once the “doughnut” shaped skin is removed, both the nipple and the areola are moved upward. When this move is complete, the skin circling the areola is now sutured into place. Excess skin –due to the stretching of the breast skin—has, in some cases, been known to pucker and wrinkle around the sutured area. Wrinkling subsides within a few weeks after the breast lift because the skin adapts to the new weight and breast shape.
Should your cosmetic surgeon feel the wrinkling will not subside naturally, a vertical strip of skin may be removed (from the bottom fold of the breast to where the chest wall connects). Skin on both sides of the incision is then pulled together and sutured. Including this additional step, when necessary, concentric mastopexy heals with less scarring than the more traditional anchor-shaped mastopexy.
Anchor Shaped Mastopexy:
A “key-hole” figure is outlined just above the areola and nipple. The cosmetic surgeon then adds an “anchor” shape near the base of the original “key-hole” outline. This “anchor” stretches from left to right across the breast.
Next, in the upper quadrant of the anchor, breast skin and excess tissue are removed. Once this skin has been successfully removed, both the areola and the nipple are moved near the lower section of the original “key-hole” outline. The last step is pulling the skin up to meet the areola and suturing it into place. That creates a fold for the lower portion of the breast, giving it a “lifted” look.
Breast lift technique is the determining factor for surgery time. These two types of surgery can average between one and five hours.
Recovery:
Following surgery, recovery times will vary – depending on the surgical technique used. It is recommended that you have someone to drive you home, following surgery and anesthesia. On average, most breast lift patients are sore between two and four days after their breast lift surgery. The most intense amount of pain is experienced within the forty-eight hours immediately following surgery.
Decreasing amounts of soreness and discomfort will last for the first 2-3 weeks following surgery. A surgical bra will also be required for the first few days following the surgery. The surgical bra is then replaced with a sports bra or surgical bandage for the next several weeks (this will be worn at all times). Sutures are removed after a week or two. No bending or strenuous activity is recommended during the first week following surgery.
Swelling and bruising may remain for the first month after surgery and the final results of the surgery may not be apparent until the end of that period. There may also be some numbness during the first 6 weeks after surgery. This should disappear, however, in some rare cases, this may be permanent.
There should be no over-the-head lifting for the first 4 weeks and no heavy lifting for up to 6 weeks after the surgery. Scarring will be very noticeable, at first, but will fade over time. However, scarring will never completely disappear. The type of procedure will determine the type of scarring and this should be discussed with your doctor, prior to surgery.
Risks Associated With Breast Augmentation Surgery:
There are standard risks associated with any surgical procedure that relate to bleeding, infection and reactions to anesthesia. Numbness can also be a factor as well as the formation of abnormal breast lift scars. The reduced ability or the complete inability to breast-feed is also a consideration.
Scar tissue can also influence mammography results and produce false positives or even conceal potentially harmful growths, in some cases. As always, a realistic expectation regarding the contour of the breasts is essential and should be discussed, in detail, with your doctor.
Procedure Costs:
The cost associated with a breast lift procedure is dependent on the type and extent of the surgery, the credentials of the surgeon and the region that the surgery is performed. Other cost determining factors include needs of the patient, anesthesia, and facilities fees. However, average costs are, as follows:
Cost Range: $4,000-$9,000
Average Total Cost: $5,200
Surgeons fee: $3,500
Anesthesiologist: $700
Facility fee: $1000
RELATED FEES**
Breast implant removal (Breast Augmentation patients only) $2,086
Breast augmentation (saline) $3,583
Breast augmentation (silicone) $4,005
Breast lifts $4,258
Breast reduction in men $3,305
**Source: http://www.plasticsurgery.org/
10 Things to Discuss with Your Surgeon During Your Consultation:
• What makes a good candidate? Which type of surgery is best for me?
•What results may I realistically expect?
•What facility will be used for performing the procedure and is it accredited?
•What kind of anesthesia is recommended for this surgery and what are the possible side effects?
•What is the total cost for the procedure and what is the cost breakdown?
•What is the surgeon’s level of experience in performing breast lifts and are patient recommendations available?
•What percentage of patients experience complications with breast lifts and what are those complications?
•What is the surgeon’s policy (additional costs, etc.) in regards to correcting or repeating the procedure if the breast lift surgery does not meet the agreed upon goals?
•What should I expect, in terms of soreness, bruising, scaring, activity level, etc. after surgery?
• Has your malpractice insurance coverage ever been denied, revoked or suspended?