Am I a candidate for Mastopexy?
How is Mastopexy performed?
Many Mastopexy procedures are performed using light sleep or general anesthesia.
The crescent Mastopexy calls for the removing of a crescent of skin above the areola moving the nipple upward and suturing the nipple into the new location. The full Mastopexy requires incisions fashioned in such a way as to actually create a new breast envelope. This allows for the repositioning of the nipple and the reshaping of the breast. Either of these operations can be performed in conjunction with a breast augmentation.
Roughly, Mastopexy takes 1 & 1/2 to 4 hours to perform.
The Crescent Lift: This technique involved removing a crescent-shaped piece of tissue above the areola and suturing the tissue higher. This creates a minor lift for patients who have slight ptosis.
The Benelli Lift: This technique is considered less invasive and was designed with the scars being around the areola. With the Benelli, a donut shaped piece of tissue around the areola border is removed and the surrounding tissue sutured to the areola. The incisions are normally closed with purse string sutures. Sometimes a little more tissue is removed above the areola to compensate for a lifting effect when it is sutured.
The Benelli-Lollipop: This lift is the same as the above but with straight incisions from under the areolae to the mammary folds (crease). This is for those who have medium ptosis, too much for the Benelli only and too little for a full anchor incision.
Full Mastopexy: The most commonly used technique is with an anchor shaped incision that starts at the base of the areola, vertically to the where the breast meets the rib cage. The incision then cuts out a crescent shape piece of skin right above where the breast meets the rib cage. Nipple re-positioning is necessary with this technique as the nipple must be removed. This is considered a major scarring technique but it sometimes necessary with severely sagging breasts.
In any case, the goal of the Mastopexy is to rid the patient of excess sagging skin and re-contour the breast in a fashion that is both pleasing to the eye and the touch. For the most part, the suture lines (scars) will fade within a year, and more so after 2 years. Those scars around and in the areola area seem to fade and flatten faster than in the regular unpigmented area. Silicone sheeting is sometimes used to hasten the flattening and fading of a scar
How long does a Mastopexy last?
Is there a lot of swelling involved with Mastopexy?
Your surgeon should attempt to make your scars as inconspicuous as possible. However, you must realize that Mastopexy scars are extensive and permanent. The scars will be red and raised for several months -- gradually fading in color and flattening out.
Nipple sensation is generally preserved with this operation. The incidence of loss is usually less than 5%. In many individuals where there is significant ptosis, the sensation has diminished prior to the operation. In these individuals, nipple sensation will sometimes increase after the procedure. However, swelling may decrease sensitivity in the nipple area and/or the breast tissue from the swelling blocking the verves ability to send and receive messages from the brain.
Is there much pain associated with Mastopexy?
Normally, there is not a severe sense of pain. Although, discomfort and soreness is what is most often described by patients. Your prescribed pain medications should alleviate the pain associated with Mastopexy. However, if you feel as if your pain is severe, do not hesitate to call your surgeon or the staff in call.
You will experience more pronounced pain if you are to remove your support bandages and bra for longer than what is necessary to sponge off. You may also interfere with your end result by going braless soon after your procedure. It is advisable to wear a bra at least for most part of the day and evening -- sleeping without -- if you must. Especially if your breasts are larger than an A cup.
What are the different techniques for Mastopexy?
The amount of sagging determines the best procedure to be performed. It is important to decide whether augmentation or reduction should accompany the uplifting procedure. The procedure that one elects to undergo is determined by several factors. First and foremost is the amount of sagging or ptosis (pronounced: toe-sis) present. When a slight amount of ptosis is present then a Crescent Mastopexy can be performed. The nipple can be uplifted 2 to 3 centimeters. The incision and therefore subsequent scar is around the top of the areola (pigmented skin). Should a greater amount of lifting be required an incision will be needed that completely surrounds the areola with a vertical line dropping down the center of the breast to the bottom of the breast and sometimes a horizontal incision at the bottom of the breast in the crease between the breast and the chest.
Also there are the undesirable scars of the Anchor (standard) Mastopexy, the Lollipop (or keyhole) Mastopexy and the newer technique invented by Louis Benelli, the Concentric Mastopexy. Also known as the Doughnut, Donut, Peri-Areolar or Concentric or Benelli Mastopexy.
What are the risks of Mastopexy?
It is possible to have a negative reaction to the anesthesia, excessive bleeding, infection, hematoma and seroma. Of course, it is given that scars will be apparent that are associated with Mastopexy. Permanent loss of sensitivity in the nipple area and breast skin is possible. If you smoke your risks are increased not to mention that your scars will heal slower and possibly wider than a non-smoker's would.
A big fear is tissue necrosis (tissue death). I am serious, you do NOT want this. Tissue Necrosis happens when either you smoke and you have poor oxygen-tissue saturation or the surgeon did not use a pedicle to keep blood flowing to your nipple or other skin sections that were reattached. It also could be just bad healing. This is an issue and by far the most worrisome and dangerous so do all that you can to keep this from happening -- like stop smoking several weeks beforehand!
Infections, although rare can happen due to bacteria such as Staph, which naturally lives on your skin. That is why it is important to wash your breasts, neck and torso with an anti-bacterial soap like Hibiclens or even Dial anti-bacterial soap for several days up until your surgery. This can reduce the amount of Staph on your skin.
What does a typical Mastopexy consultation entail?
At your consultation, your surgeon should measure your breasts and general torso area to determine a natural and aesthetically pleasing position for your breasts and areola/nipple complex post-op. You should provide your surgeon with photos of your breasts previously in life, if possible. If not, a bathing suit photo may help. Your surgeon should take into account your skin condition and (i.e. elasticity and thinness) and age. Sometimes a surgeon will offer the option of having an implant inserted if there is barely any breast tissue remaining.
Your surgeon should discuss with you the details of how a Mastopexy is performed, explain the possible risks and complications involved and any post-operative special care instructions. He/she should also discuss with you ALL costs involved so that you are not surprised by hidden costs. Discuss with your surgeon any questions or concerns you may have before deciding whether or not to commit to Mastopexy.
What is Mastopexy?
The Mastopexy or breast lifting operation is really several different procedures. Each of the different operations has as its intended purpose to lift the breast up and position the nipple in the position that it was in before sagging occurred. Sagging occurs due to three circumstances either alone or in conjunction with each other. First, after pregnancy and breastfeeding the breast has become stretched and the skin loosened. Frequently there is actual loss of some of the breast tissue and this allows for sagging also. Second, weight gain and loss can stretch the skin and also create sagging.
Third, the process of aging and the effects of sun and gravity tend to decrease the elasticity of the skin and this can be a significant factor creating sagging of the breast. The goal in all these instances is to move the nipple back to a higher position and to reshape the breast to create a more beautiful appearance. Most often the need for excess skin removal is apparent.
What should I expect post-operatively?
Sutures will have been placed underneath the skin. These will dissolve over several months. Sutures will have been placed onto the skin and these are most frequently the type that will dissolve in one week. A special tape is placed over the sutures to help protect the wound. A bra will be worn continuously for 21 days, 24 hours per day. Instructions on bra removal for washing will be given after the surgery. There is generally very little pain after this operation and only a moderate amount of swelling. The patient may return to work in 3 to 4 days unless the work involves bending or lifting. Walking may be resumed the day after surgery.
More than likely, a surgical will have been be put on you over your gauze bandages. This may be replaced by another bra or you may be asked to wear this particular bra for about 21 days - non-stop. This should be adhered to as non-compliance could affect your end result and or healing. Your stitches will be removed if they are of the non-dissolving kind. If not the special tape will be removed by you in the shower at the end of the 21 days.
It is quite possible to have loss of sensitivity in the nipple and breast skin due to the swelling. The swelling blocks the nerves ability to send and receive pain and pressure messages to and from the brain. This may resemble a numb feeling and is quite normal. Most sensation returns within 1 to 3 months or possibly up to a year or more. Unfortunately, some instances prove that the loss of sensation is a permanent one.
When can I return to work?
You may not feel like doing much for a few days post-operatively. Although after the first three days you may be up and about, walking around thinking you are feeling fine. But in reality you are still able to take your pain medications and have the option of lying down if need be. If you are at work and must work for 8 hours - or even half of that - the option of lying down and popping a few pain medications is more than likely ruled out. Just be sure that no matter what you do, do not lift anything over your head (including your arms) for at least 10 days or until your doctor specifies otherwise.
No strenuous activities, including hard labor or exercise, for at least three weeks. In some cases, you are not allowed to have sexual relations until at least 7 days, post-operatively.
When is Mastopexy usually performed?
When will I be able to see the results?
Where are the scars located involving Mastopexy?
The scar from the crescent Mastopexy is placed directly at the junction of the areola (pigmented skin) and non-pigmented skin. It heals leaving a scar that is barely visible in most people.
The full Mastopexy involves more incisions. The anchor shaped scar is normally the chosen incision line. However different doctors have different techniques. The scars are generally very well tolerated by patients as the scars are far less unsightly than the sagging breast. Over the course of 12 to -24 months the scars fade dramatically and in many individuals are not very noticeable. In some individuals the scars will always be somewhat visible, generally seen as a lighter area on the breast.
The Benelli leaves just a scar around the areolae (darker pigmented area). The Lollipop (or keyhole) leaves a scar around the areolae and straight down to the natural crease where your breast meets your rib cage.
All patients undergoing Mastopexy should be certain that they understand the incisions and resulting scars. When the patient knows ahead of time what to expect, it is most likely that the scars are not nearly as noticed as is the much improved beauty of the breast due to improvement of the shape and positioning of the nipple.