Breast Lift Surgery/Procedure Options

Performed in Our Houston Office by Dr. Cara Downey

A breast lift, also known as a mastopexy, is indicated for women who have an adequate amounts of breast tissue, but improper placement on the chest wall or less than ideal position of the nipple relative to the breast mound. They may also have poor projection or deflation (floppiness). This may be substantial, as a result of massive weight loss or may be mild as a result of breast feeding or even the effects of gravity over time. The goal of a lift is to remove excess skin from the lower portion of the breast and re-suspend the tissue to its original position on the chest wall. The nipple is also centered in the correct location of the newly shaped mound.

Results May Vary

TYPES OF BREAST LIFTS

• “WISE” Pattern (classic anchor incision”) A breast lift can be accomplished by using incisions similar to a classic breast reduction, which involves a scar around the nipple, a vertical line from the bottom of the nipple to the fold of the breast and along the fold of the underside of the breast. This is typically required if a lot of reshaping is needed or there is an abundance of excess skin.

• “Lollipop” incision. If less degree of excess skin is present a lesser incision may be possible that involves a scar around the nipple, vertical to the chest wall without an incision along the underside of the breast (“lollipop”).

• Peri-areolar. If the breast mound is in good position and it is just a matter of moving the nipple to a higher position with minimal tightening of the breast, the incision can be limited to around the cicumfrence of the nipple or even just the upper half (cresenteric)

The choice of incision may be dependent on the degree of excess skin and nipple position.  A lift will make your chest feel firmer and higher, but remember that you must have realistic goals set for this surgery and you must be willing to trade a scar for an improvement in position and shape.

Who Can Benefit from a Lift?

• Lowered breasts from age and gravity
• Deflated breast from pregnancy and/or breast feeding
• Deflated breast from massive weight loss
• Low lying nipples
• Breast Asymmetry with or without the above – a small amount of breast tissue may be taken from a larger breast to improve symmetry during the lift procedure.

What Do I Need to do to Prepare?

Ideal candidate for breast surgery include those with good breast health. Women over the age of 40 or with significant family history of breast cancer/disease would require a screening mammogram prior to any breast surgery. Women with abnormal breast complaints, such as irregular nipple discharge, skin dimpling or recent changes to the breast or any lumps or bumps should seek a work up to ensure no underlying breast pathology.

Those who have recently given birth should wait a minimum of 6 months after birth or after breast feeding to allow the breast to settle to its final state. If planning a future pregnancy, surgery may not be advisable until after. If future pregnancy is undecided, the risk of inability to breast feed following a breast surgery as well as changes to the breast during and after a pregnancy should be discussed and weighed.

All patients undergoing a mastopexy procedure should be NON-SMOKING for a minimum of 4-6 weeks prior to surgery and must refrain from smoking during the 6-8 weeks following to ensure proper recovery, avoid wound healing and scarring issues and prevent the most dreadful complication of nipple loss.

Patients should also strive to eat healthy including a diet with adequate lean protein and vegetables. If nutrition is of concern, consider a multivitamin and/or supplementation with protein shakes.

Is Mastopexy Covered by Insurance?

Typically, since a mastopexy is more about the cosmetic appearance of the breast and less of a medically necessity, it is not covered by most insurance plans. If the lift is incorporated in a large volume reduction of breast tissue, it may be covered by insurance.

What Can I Expect on the Day of Surgery?

Mastopexy is often a minor to moderate procedure that does not require hospital stay though patients may choose to stay overnight for an additional fee.  You will be asked to arrive to the hospital 1-2 hours before the start of your surgery, when the hospital staff will prepare any necessary documentation such as have you sign a consent form. You will meet and talk with the anesthesiologist team as this procedure would require general anesthesia during which time you are completely asleep and supported by a breathing machine. The nurses or anesthesiologist will place an IV and start fluids. Your surgeon will greet you just before surgery and place marks on your breast with a marking pen. You will then be taken to the operating room and placed on the operating table, where you will gently be put to sleep. You will awake in the recovery room with only minimal discomfort and will have dressing and a bra in place. Your family will be instructed on your care prior to leaving the recovery room.

It is advisable to rest that day and avoid foods that easily upset the stomach such as dairy and heavy proteins until you feel the anesthesia is waring off, which may take up to 72 hours.

What Are The Risks?

As with any surgery, there are risks which may include….

• Poor wound healing
• Poor scaring (especially if prone to keloids or hypertrophic scarring)
• Infection
• Asymmetry
• Changes in nipple sensation (increased or decreased)
• Nipple loss in rare cases.

***Smoking increases these risks substantially. Dr Downey will discuss these potential complications in detail during your office visit just prior to your scheduled surgery date.

What Is the Expected Recovery?

Immediately after the surgery and for the following few days, you shouldn’t plan on heavy lifting or doing intense workouts, as you must let your body heal. Mastopexy surgery is typically not a very painful procedure and you can expect to be off narcotic medication after approximately 72 hours. You can expect breast soreness to last around 2 weeks. During the first 2 weeks you should gradually resume normal day to day activity but avoid anything that raises the heart rate and blood pressure. After 2 weeks, you can start gentle low implant exercise with good breast support. You will need to avoid any jarring, jumping activity for at least 4 weeks. By 6 weeks you will be released to any and all activity assuming no delays in recovery but it will always be advised to have good support with intense activity. You may be asked to avoid wearing any underwire bras for the first 6 weeks if your incision involves the lower fold of the breast