Breast Lift (Mastopexy)

Breast Lift (Mastopexy)

Women may experience significant changes in their breasts after pregnancy, breastfeeding, weight loss and aging. The breast size diminishes and the skin becomes saggy. The breasts becomes droopy and take on a pendular shape. The nipples drop to a lower position and the areolae increase in diameter. Large breasts tend to be more prone to sagging compared to smaller breasts, although any woman may experience these problems.

Ptosis is the medical term for droopy breast. The severity of breast ptosis can be graded by using Regnault’s Classsification:

Normal breast has the nipple and parenchyma (glandular tissue and fat which compose the breast) of the breast sitting above the crease underneath the breast, or the inframammary fold.

Grade 1 ptosis is mild sagging in which the nipple lies at the level of the inframammary fold and the parenchyma below it.

Grade 2 ptosis is moderate sagging in which the nipple lies below the level of the inframammary fold but remains above the lowest hanging (or most dependent) part of the parenchyma.

Grade 3 ptosis is severe sagging in which the nipple lies well below the inframammary fold and lies at the bottom of the breast, at the lowest hanging part of the parenchyma along the inferior contour of the breast.

Pseudoptosis is not true ptosis, because the nipple lies above or at the level of the inframammary fold. However, the majority of the breast parenchyma has descended below the level of the fold.

Breast lift surgery, also known as mastopexy, is a surgical procedure to correct breast ptosis. Breast lift surgery lifts droopy breasts by the removal of excess skin and tightening of breast tissue. A breast lift does not make the breasts bigger in size, but it does make the breasts uplifted, feel firm and appear more youthful. A mastopexy uses the identical incisions as in a breast reduction surgery. The difference between mastopexy and breast reduction is that in addition to the removal of skin and tissue tightening, breast reduction surgery involves removal of  underling breast tissue to reduce the size of the breasts. Breast lift surgery does not involve removal of breast tissue and there is no reduction of breast size. Breast lift surgery is commonly combined with breast augmentation for women who have both volume loss and drooping of the breasts.

Preparation

1. Inform the doctor of any pre-existing medical conditions and drug allergy. All medical conditions must be treated and stabilized before surgery.

2. Stop smoking at least one week before surgery. Smoking is harmful to wound healing and increases the risks of other post-operation complications.

3. Stop the following medications and supplements from one week before surgery until one week after surgery.

   1. All supplements containing vitamin E, ginseng, ginkgo, garlic, fish oil, and other ingredients that increase bleeding during the procedure. Other supplements, traditional medicine, and herbs, in which ingredients are unknown, have to stop as well.

   2. Medicine that increases bleeding during the procedure such as aspirin, NSAIDs, and warfarin. However, you may need to consult your physician who prescribed the medication before you stop them.

4. On the day of surgery, wear simple and comfortable clothing. Do not wear any makeup. Do not wear any jewelry and metal objects on the face and body.

Surgery

Duration: 3-4 hours

Anaesthesia: General Anaesthesia

Hospitalization: One day

Recovery*: Back to work in 7 days, light exercise after one week, heavy exercise after 4 weeks. * The actual speed of recovery may vary from person to person.

Surgery Technique:

Mastopexy techniques are similar to breast reduction surgery except there is no removal of breast tissue. As in breast reduction surgery, three options are available:

1. Vertical short scar technique: an incision is made around the areola, with another vertical incision from the areola down to the breast’s lower edge, forming a “lollipop-shaped” scar. Compared to the inverted-T technique, vertical short scar technique produces a much shorter scar and the overall shape of the breast looks more natural and uplifted. Vertical short scar technique is the technique of choice in our practice.

2. Inverted T technique: an incision is made around the areola, with another vertical incision from the areola down to the breast’s lower edge, plus a horizontal incision along the lower border of the breast. Among all the techniques in breast reduction, this technique produces the most scars on the breast. Inverted-T technique is used for very severe cases of breast ptosis.

3. Periareolar mastopexy: The only scar is around the areola. This technique only works for cases of minor severity.

Post-operative Care**

1. What to expect:Swelling usually peaks on the second to third day after surgery and will gradually subside after that.

2. General care:

   1. Wear a special supportive bra for at least one month.

   2. Avoid smoking for at least one month. Smoking increases the risk of wound complications.

   3. Adequate rest and sleep are helpful for a speedy recovery.

   4. Sleep on the back. Avoid sleeping on one side to prevent pressure on the breast.

   5. Be relaxed and calm. Contact the clinic if there are any queries.

3. Medicine: Finish the oral antibiotics as prescribed. Take the painkiller when necessary.

4. Wound care:Leave the wound dressing on until coming back for review. Change the wound dressing if it gets dirty or soaked. After removing the wound dressing later, clean the wound with a clean cotton tip soaked with sterile water/saline. Apply antibiotic ointment.

5. Physical activity:Avoid heavy physical activity and exercise for at least one month.

6. Follow-up: Come back one week after surgery for review.

7. Emergency:If there is heavy bleeding, a rapid increase in swelling or severe pain, contact the clinic/doctor for advice immediately.

** The instructions in this list are only for general guidance. If you have any specific queries or concerns during the post-operative recovery, please contact the clinic for further advice.