A breast lift, or mastopexy, is performed to return youthful shape and lift to breasts that have sagged as a result of weight loss, pregnancy, loss of the skin’s natural elasticity or simply the effects of gravity. The procedure can also reduce areolar size (the dark skin surrounding the nipple), and can be combined with mammoplasty (breast augmentation) for added breast volume and firmness. Breasts of any size can be lifted, but results last longest when they are originally small and sagging.
Women planning to have children are advised to postpone surgery, since pregnancy and nursing can counteract its effects by stretching the skin. However, in general, mastopexy should not affect your ability to breastfeed.
Mastopexy may be performed in a hospital, an outpatient surgery center or a surgeon’s office-based facility. It is usually done on an outpatient basis under general anesthesia, and lasts from 1-½ to 3-½ hours.
A number of pre-operative steps are typically taken such as a mammogram, pictures and measurement of the breasts. There are various techniques of mastopexy and the incision is made based on the technique chosen. A mastopexy is designed to removes excess skin, relocate the nipple and areola, and reshape the breast using skin from around the areola before closing the incisions with stitches.
Patients with small breasts and minimal sagging may be recommended for limited-incision mastopexy. One such modified procedure is concentric periareolar mastopexy, in which two concentric circular incisions are made around the areola and a doughnut-shaped swathe of skin is removed, leaving only an incision around the nipple.
After surgery the breasts are wrapped with gauze dressings, over which an elastic bandage or a surgical bra is placed. After a few days this is replaced with a soft support bra which is worn 24 hours a day for about a month. Breasts will probably be bruised, swollen, and uncomfortable for a few days but this will pass. Numbness in the breasts and nipples should lessen as swelling subsides, although occasionally it lasts for months or even permanently. Stitches are usually absorbable or are removed after one to two weeks, and many patients return to work then.
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