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Breast Lift : Mastopexy

A breast lift may be performed at any age, although most plastic surgeons recommend waiting until breast development has been completed. Pregnancy and breast-feeding may affect the size and shape of a woman's breasts, so you may wish to postpone surgery until after having children. There are still many women who go through surgery before having children, knowing that they may have pregnancy-related changes later.

You may be a good candidate for breast lift surgery if you have any of the following conditions:

  • Breast firmness or substance which is "sagging", but a size that is satisfactory to you
  • Nipples and areolas moving downward, especially if they are positioned below the crease of the breast

In some cases, women have breast lift surgery to correct inherited traits or asymmetry (one breast may be well-developed and in the appropriate position while the other is not).

Surgical Options

There are different techniques available for breast lift surgery. Your anatomy, surgical indications and your desired result will determine the specific method chosen. The most common method of breast lift surgery involves three incisions. One incision is around the areola (the dark part around the nipple). Another runs vertically from the bottom edge of the areola to the crease underneath the breast. The third incision is a horizontal incision beneath the breasts that follows the natural curve of the breast crease. There are other methods that may reduce the amount of incisions, and this is determined at the consultation depending on the surgical indications and the patients desires

Anchor lift: This lift involves all the above incisions. With this operation Dr. Yousif performs a special internal architectural positioning of the breast tissue to provide superior fullness and aesthetic shape. This procedure is usually done when a patient does not want increased volume but only a lift.

Vertical lift: The vertical lift is a lift does not have the horizontal portion of the scars beneath the breast. It has been called the "Lollipop Lift". Although this can be done without an implant it is most often done along with implant placement. When this is done in combination, Dr Yousif has found that placement of the implant through a trans axillary (arm pit) gives the best results.

Periareolar Lift: This is a lift with only an incision around the nipple areolar complex. The procedure was popular in the 1990's. The reduction of scars is an advantage however this procedure has certain problems. It tends to flatten the breast and the incision around the nipple areolar complex has puckering around it. Although the puckering improves with time the flatness of the breast does not. Dr. Yousif only finds this indicated for small lifts.

Following removal of the excess breast skin and shaping of the remaining breast tissue, the nipple and areola are shifted to a higher position. The areola, which is sometimes overstretched in the sagging breast, may also be reduced in diameter. The nipple is lifted to the appropriate position and the skin is closed around it. The nipples and areolas remain attached to the underlying breast tissue, thus typically allowing for the preservation of sensation and the ability to breast-feed.

If you have decided that your breasts will be enlarged at the same time they are lifted, breast implants will be required (refer to Breast Augmentation in the procedures section).

Recovery

Within the first week following surgery, you will begin to move about more comfortably as the days go on. You may be able to return back to non-strenuous work within 7-10 days following surgery. The chest wrap is usually removed in the office within a couple of days following surgery. A support bra is then worn for 4-6 weeks. Most stitches dissolve on their own.

After several weeks, any bruising, swelling and normal periodic discomfort will diminish. The support bra, at this point, may also be discontinued. Sensation within the nipple and areola will gradually improve. After about 4 weeks, you may return to most of your normal activities including exercise and lifting.

After a few months, your breasts will start to settle into a more natural shape. Incision lines which initially are pinker, will begin to fade.

Patient Testimonial

"Dr. Yousif does miracles. A few years back, I had a mastectomy and a lumpectomy on different breasts, leaving me uneven. Dr. Yousif fixed mistakes that were done by another surgeon. I'm very happy with my results. He has a passion for perfection!"

The Combined Lift and Augmentation

The combination of breast lift and augmentation or breast enlargement is a difficult procedure. It is difficult because several things are changing at once and will change over a period of time after surgery. After surgery implants tend to drop somewhat and the nipple and breast after a mastopexy takes time to reach its final shape. Because an implant must sit behind the nipple and because things change after surgery it is difficult to get everything to sit where they should. Second surgeries are not infrequent to finalize the outcome. Dr Yousif prefers to perform the combination at the same time but separates the incisions. The lift is done as a vertical lift and the implant is placed by a transaxillary route. This allows him to place a temporary implant though the arm pit, then do the lift and see how that looks and make sure the implant is in the correct position and the correct size. Once that is done and the lift incisions totally closed the final implant is placed. Dr Yousif feels that this gives the best chance to for the procedure to be successful.

Anesthesia and Surgery Facility

General anesthesia is the usual approach, though local anesthesia with IV sedation may be considered for more minor alterations. This is routinely an outpatient procedure. Operative time is usually 2 hours.

Side Effects

With the general anesthesia, a recovery process at the surgery center/hospital typically ranges from 2-3 hours. Gauze dressings will be placed on your breasts and covered with an elastic bandage for support and to reduce swelling. There is chest discomfort which is usually described as soreness and tenderness, and this can be controlled with pain medication both at the facility and once at home.

Risks

Though thousands of women undergo breast lift surgery each year and experience no major complications, it is still important to be informed of the risks. As with any surgery, there is a risk of bleeding and infection, though these are uncommon. There is a greater risk of scars widening or poor healing for individuals who do not stop smoking prior to or within the healing period after surgery. Breast lift surgery does leave permanent scars, although they will lighten over time, and will also be covered by your bathing suit or bra. The procedure can result in nipples that are not evenly positioned or a slight risk of permanent loss of sensation in your nipples or breasts. Most of those things can be corrected with small procedures . Although some sensation loss is permanent most the nipple sensation typically returns over the 6 month post operative period. As with any surgery, you can reduce your risks by closely following instructions, both before and after surgery.

Duration of Results

This may be variable as implants may require replacement over a woman's life span, most implants last for many years without problems.

After breast lift surgery, your breasts will feel firmer and appear more youthful and uplifted. You can expect to maintain your new breast shape, unless you gain or lose a significant amount of weight or become pregnant. If, over time, you again become dissatisfied with the appearance of your breasts, you may elect to undergo an additional procedure to help restore the breasts more youthful contour and appearance.