Breast Lift FAQ
As women age there is a natural tendency for the breast to descend. The skin of the upper breast loses its elasticity and the skin stretches. In addition, the breast tissue itself becomes less firm and decreases in mass or atrophies. This results in breasts that have “shrunk” and “dropped” or in “saggy breasts”. Cosmetic surgeons will generically refer to this as “ptosis” and will grade a breast by its “degree of ptosis”.
Breast ptosis may become apparent to a woman while she is still relatively young after she has had children, or it may appear in middle age. Variables which will affect the degree of ptosis are the elastic qualities of the skin, the number of pregnancies, the age at the time of pregnancy, the size of the breast, and the characteristics of the breast tissue itself. Having ptotic breasts is normal, just as getting wrinkles as you age is normal.
What is a breast lift (mastopexy)?
A breast lift is a surgical procedure that elevates the position of the breasts. This surgery is designed to lift sagging breasts to a more youthful, aesthetic position upon the chest. If there is excess skin, it is removed. The nipple is repositioned to a more youthful position as well.
It is the position of the nipple and the amount that it needs to be raised that will determine the procedure that needs to be performed. A youthful breast has the nipple above inframammary fold . A mature but aesthetically pleasing breast has a nipple positioned at approximately the same level as the inframammary fold (IMF). The surgeon’s goal is to raise the nipple to or above the IMF depending on the patient’s age, desires, and characteristics of their breasts. Breasts with ptosis can be lifted and made larger simultaneously by simply placing a breast implant, i.e. breast augmentation.
Who Is A Candidate For A Breast Lift?
A patient with grade 1, 2, or 3 breast ptosis who wishes to reposition her nipple and breast tissue to a more youthful position may be a candidate for the procedure. This is done with or with simultaneous breast augmentation.
Are There Women Who Should Not Have A Breast Lift?
Women who smoke, have a high risk of breast cancer (scars may make reading mammograms difficult), or are unwilling to accept scars on their breast, a potential decrease in nipple sensation, or the ability to breast feed should not have this procedure. Also, women with very large breasts who only want a lift will ultimately be disappointed because of a high rate of recurrence unless a breast reduction is performed.
Breast lift vs breast augmentation: How to tell which is needed?
What you need to remember is that “augment” means to add to, or make bigger. A breast augmentation will make your breast bigger. A mastopexy is a breast lift which elevates the breast on the chest back to where they used to be. . The two procedures are by no means mutually exclusive; in fact, we perform combined breast augmentation with a mastopexy or breast lift quite frequently.
What types of breast lifts are there?
Here is a description of the different incision patterns and techniques used in breast lift surgery. These are listed in order of increasing amounts of scar AND increasing amounts of lift.
- The “anchor” incision, made around the perimeter of the areola, vertically down from the areola to the breast crease and horizontally along the breast crease, produces the most scarring. It is for women with a severe degree of sagging who will not be helped sufficiently by less invasive techniques. This incision, which is the oldest technique, is often used for a breast lift in conjunction with a breast reduction. Some women simply have too much skin for a vertical lift and must have the Wise pattern or anchor shaped scar. The long horizontal component of this scar is the area most likely to produce a thick highly visible scar, but as in all mastopexies, it is a trade off. More scar, less excess skin, and resulting better breast shape.
- The “lollipop” lift, also known as a “keyhole” incision, made around the perimeter of the areola and vertically down from the areola to the breast crease, is suitable for women with a moderate degree of sagging who will not be helped sufficiently by the periareolar technique. This mastopexy works well to not only lift but to narrow the breast.
- The “donut” lift, also known as the “periareolar incision,” made around the perimeter of the areola only, is suitable for women with a mild-to-moderate degree of sagging. This lift does not affect the overall shape of the breast much, it only repositions the nipple. When used with the placement of implants, it produces a very satisfactory result.
- The “crescent” lift, which is less commonly used, is an incision that lies just along the upper half of the areola. A crescent-shaped piece of skin is removed above that line, and the surrounding skin is reattached to the areola. This type of lift is usually done in conjunction with breast augmentation in women with minor sagging. It cannot accomplish the same degree of lifting as the other incision techniques.
Can breast lift with implants provide symmetrical breasts?
Symmetry in breasts is always tricky. I like to remind patients that breasts are sisters, not twins. They are never absolutely symmetrical. While asymmetry in the breasts can be the result of asymmetry in breast size, breast shape or breast position, it can also be the result of asymmetry in the chest wall, the ribs or a scoliosis (a curvature of the spine). Many times we don’t notice our own inherent breast/chest asymmetries until we make the breast larger. Having said that, acceptable symmetry can usually be achieved.
What kind of anesthesia is used?
Breast lift surgery can be done easily using IV sedation with local anesthesia. Anesthesia techniques have come a long way, and the less safe general anesthesia is now only required infrequently.
How long does breast lift surgery take?
It all depends on how much lifting needs to be done and whether or not a breast augmentation will be done at the same time. The surgery can last between 2 and 4 hours.
Are Drains Placed?
Sometimes drains are used, depending on the technique used. The fluid will drain into a collection device that can easily be emptied. The drains will usually be removed 1 to 3 days after surgery. Removal of the drains is not painful.
How much bruising, swelling and pain is there?
After surgery, the breasts will have a moderate amount of swelling. Most of the swelling will resolve over 2 to 4 weeks. The breasts will appear slightly larger than they will ultimately be because of this swelling. Both breasts may have some bruising that is generally mild and resolves over 1 to 2 weeks. The amount of pain post-operatively is patient dependent. Some patients will experience only mild discomfort, particularly with raising the arms and with increased activity. It is unusual to have significant pain. The vast majority of patients report the pain as tolerable. Some patients have reported difficulty getting comfortable when going to sleep for the first 1 to 2 weeks. Patients may also experience hypersensitivity of their nipples. For the most part, all of the pain and discomfort resolves completely with time, generally 2 to 4 weeks. Pain medication is given to all patients to help keep them comfortable post-op.
Should I wait until after pregnancy to get a breast lift?
Pregnancy can significantly change a woman’s breasts. Dr. Light usually recommends that if a patient is going to get pregnant in the next year, she should delay breast surgery because the breast will be different after pregnancy. How different a breast will become is impossible to predict. That being said there is no risk with pregnancy after an augmentation or lift, you just run the risk of requiring another surgery.
What happens before I have the surgery?
You will first have a consultation with Dr. Light to discuss your particular case. Once you have decided to proceed with the surgery and have scheduled a date, you will return for a second visit at which time Dr. Light will review the surgery with you, photos will be taken, consent forms will be signed, and further instructions and prescriptions will be provided. Full payment is made prior to surgery (or financing is arranged). You will have lab tests drawn and an electrocardiogram done by your primary care physician (or we will recommend where to do this) one to two weeks prior to the surgery.
What happens on the day of surgery?
You will arrive at the office surgery center. You will not have eaten or drank anything since midnight the night before. You will be checked in and your vital signs will be taken. You will put on a gown. An intravenous line will be started. Dr Light will mark your breasts with a marker.
What happens after surgery?
Bandages will be placed. You will recover for 1 to 2 hours in the recovery room. You will then be driven home by a friend or family member. Your activities will be limited for the first few days. It is advisable that you not drive for at least 3 to 5 days after surgery. As the pain and swelling decreases you will be able to resume normal activities. Dr Light will allow you to resume strenuous exercise with your arms after 4 to 6 weeks. You may be able to resume exercise with your legs (walking, jogging, bicycling, etc) sooner.
When can I get back to work? When can I drive a car?
For sedentary work with minimal physical activity you can expect to go back after 3 days. For moderate activity, it will take about 7-10 days to be comfortable. For manual type labor with heavy lifting, you will need to wait 2 to 3 weeks. It will take 3 to 7 days to be able to drive safely, depending on your pain tolerance, how much pain medication you are taking (if any), and whether you drive an automatic or manual transmission automobile.
Will the scars be noticeable?
Although incision lines are permanent, in most cases they will fade and significantly improve over time. Aesthetic surgeons make every effort to place scars in hidden areas and minimize them, with the goal of achieving the desired results with the shortest possible scar. The scars will typically lighten over a one year period.
Will this surgery affect future mammograms?
Yes. There will be some scar formation on the inside of your breast. A mammogram done after surgery will very likely look different than one before surgery. You should obtain a mammogram approximately 1 year after surgery for a new baseline. Afterwards, the frequency of mammograms will depend on your age.
Will I be able to breast feed after a breast lift?
Because for the most part, the connections between your breast tissue, breast ducts and nipple are not interfered with a lift, your ability to breast feed should not be affected
What are the potential risks of breast lift surgery?
The risks include unattractive scars, loss of nipple sensation, infection, numbness on breast skin, asymmetry, inability to breast feed, loss of nipple, and most commonly, recurrence of ptosis. Obviously, the factors which caused the problem initially, (aging skin, heavy breast, pregnancy, etc,) may be present after surgery so that recurrence of ptosis is very possible if not likely.
When will I see the final results?
It will take 3 to 4 weeks for most of the swelling to resolve and probably 3 months for all if it to resolve. After this you should have a reasonably good idea of what the final look will be. Your breasts may still be a little firmer than they will ultimately be, however. It often takes months before the breasts feel very soft and natural.
Is a breast lift permanent?
Unfortunately, as you age, your skin ages and loses its elasticity. Because of this, the weight of your breasts will cause the breast ptosis to recur to some extent. The exact amount the breast will “drop” and the amount of time it will take for this to occur is very patient dependent. It will vary with age, skin quality, and size of breasts.
How much does a breast lift cost?
That depends on the type of lift needed and whether or not you are adding an implant to the surgery. Prices generally range from $4,800 to $9,700.