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Breast lift

If drooping breasts are a concern, perhaps after weight loss or pregnancy, some women consider a breast lift cosmetic surgery procedure.

A 'pencil test' is sometimes performed to see whether the procedure would be beneficial. If a woman places a pen or pencil underneath her breast and the item stays in place without assistance, she may benefit from a breast lift.

The most common breast lift operation is the mastopexy. It involves repositioning the nipple areolar complex to a location higher on the chest wall. The incisions are located around the nipple areolar complexes. This operation is performed with the patient under general anaesthesia and takes approximately three hours. It will often involve an overnight stay in hospital depending on the extent and size of the procedure.

Some patients will have lost quite a bit of breast fullness and may require the placement of breast implants in addition to the lift. In this case, the lift is performed in the usual way, and the implants are placed most often underneath the muscle.

Once a procedure is chosen, the cosmetic surgeon should describe it in detail to the patient and explain that her incisions will be red and noticeable for up to a year, and sometimes longer. If a patient’s expectations are realistic, she should be satisfied with her results.

What age is appropriate to proceed with a breast lift?

A breast lift can be performed at any age, but cosmetic surgeons usually recommend that once breast development has stopped is a perfect time to proceed with a breast lift if it is considered necessary. If patients are interested in having children first, a breast lift can be performed after pregnancy. However, if patients are extremely concerned about ptotic or droopy breasts prior to pregnancy or having children, a breast lift can be performed without impacting breast-feeding. The milk ducts and nipples are left intact, and the breast lift surgery usually does not affect your ability to breast-feed. Details such as this will be discussed with you by your cosmetic surgeon prior to your procedure.

Most breast lift operations are considered cosmetic and are not usually available on the NHS. Occasionally, if a patient has a breast reconstruction on one side and the opposite breast is ptotic or quite droopy, a single breast mastopexy will be performed to improve the appearance of both sides. The NHS may cover this, although different health areas have different criteria for deciding who is eligible for treatment.

Getting ready for the surgery

Once you’ve consulted with a cosmetic surgeon, there are some things about mastopexy that you need to consider. First and foremost, the procedure that you have discussed with your surgeon will improve the appearance of your breasts, and they will be higher on your chest wall. You may consider augmentation to create more fullness and ultimately give a better shape and look to the breast. Your clothes will fit better as the contour of your body reveals the improvement, and this will be especially noticeable in lingerie and swimwear.

It is most important to understand that there will be scars. The majority of patients heal very well following this procedure, but occasionally there may be some scar irregularities, in which case touch-up procedures or scar revisions will have to be done. In some cases, tattooing can improve the appearance of the nipple areolar complex.

If implants are to be used, it’s best if the patient brings in photos with pictures of the size and shape of breasts she wants. This helps the doctor understand precisely what the patient expects.

Once the procedure is chosen, the patient will be scheduled for a preoperative appointment approximately ten days to two weeks prior to the surgery.

At that time, your cosmetic surgeon will answer all questions, take pictures, and confirm that the patient is healthy. If you smoke, you will need to stop before the procedure and not smoke after the procedure. There can be problems with blood supply to the nipple areolar complex, and this can occur when patients smoke or even are near second-hand smoke. Second-hand smoke is responsible for 50% of complications in patients who experience problems following surgery.

The actual operation is likely to take place in a hospital setting or your doctor’s personal operating room. The patient will meet with the anaesthetist, surgeon and nursing staff prior to the procedure. The surgeon will mark the correct position of the nipple areolar complex and do markings with the patient in a sitting position. This is the position the breasts will ultimately be in when she stands up. Markings done on the patient who is in a lying down (supine) position will give inappropriate position changes for the nipple areolar complex.

Under general anaesthetic the operation involves the removal of excess skin and lifting of the breast tissue up into the correct location. Saline implants are used most often when this is part of the operation. They are slipped underneath the muscle through one of the access incisions that was used for the lift. The actual placement of the implants will help lift some of the tissue as well, and this needs to be considered when designing the breast lift prior to the procedure. All of this is followed by the closing of the incision lines in layers.

Following the procedure, your surgeon may or may not use little drains. If used, the drains are usually removed within the first 24 to 72 hours. Following this, a sterile dressing is applied.

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