BREAST LIFT (MASTOPEXY)
This procedure is indicated for women who have sagging breasts, as opposed to empty breasts (which would benefit from breast augmentation). Sagging breasts are characterized by laxity of the skin and excess skin in the upper part of the breast, causing the nipples to descend to a lower position. In addition, the nipples often point downwards. A breast lift involves relocating the nipple areolar complex to a higher position and removing the excess skin to tighten up the breast. In addition, the areolas are usually too large, so they are reduced to a more normal size.
A breast lift restores the breast to its previous youthful and taut appearance and shape. The scars associated with the procedure comprise one that encircles the newly relocated areola, a vertical scar that runs from the lower margin of the areola down the middle of the breast, and which joins a short horizontal scar along the crease at the bottom of the breast (the inframammary fold). These scars are necessary in order to achieve the effects of the breast lift. However, they tend to fade well and become inconspicuous with time. Most patients who undergo a breast lift end up feeling that the scars were worth the benefit of regaining a youthful looking breast.
This operation is carried out under general anesthesia as a day surgery procedure and takes three to four hours to complete. Incisions are made around the new location of the nipple areolar complex, extended downwards on each side of the areola and angled inwards until they meet close to the bottom of the breast. The skin below the areola and within these boundaries is removed. The areola is reduced in size by excising a rim of excess areola and is then moved up to its new, higher location. The defect left from the skin removal below the areola is closed by bringing the wound edges together with strong sutures. Excess skin at the bottom of the breast is then excised. Bleeding is carefully controlled. The skin wounds are meticulously closed with stitches.
Postoperative pain is minimal and easily controlled with oral pain medication. There is mild swelling and bruising. The stitches are removed after two weeks. A supportive surgical bra is worn for the first one month. Daily activities may be resumed almost immediately and exercise is allowed after one month.
A breast lift is generally a very safe procedure, with minimal blood loss and a very low risk of infection. With good planning and execution, the blood supply of the nipple areolar complex is safely preserved, ensuring its viability and optimal wound healing. Nipple sensation is usually not affected. The scars need at least one year to fade completely but with good scar management they tend to fade well and complications such as keloid scars are uncommon.