Breast Lift

A breast lift or mastopexy procedure is plastic surgery to uplift and enhance your breast shape. Women with droopy breasts following weight loss or with a deflated chest after pregnancy are encouraged to consider a breast lift.

About

As breasts age, all its components stretch out and lose their tone of earlier years. This can result in droopy and deflated breasts. These natural changes can be accentuated even more following pregnancy, breast feeding, and any other situations that lead to weight gain and loss.  With weight gain, the skin, stretches along with the retaining ligaments of the breast. In some, this can result in stretch marks or tears in the deepest strongest layer of the skin, known as the dermis. Following weight loss, the skin may not be able to shrink commensurate with the volume loss. 

Just like a balloon that is blown up, all its components stretch. When the air is removed, it shrinks back, approaching that of its original shape, but often not to its original shape. The longer the balloon is left stretched, the more difficult it is to return to its original shape.

To tighten and reshape the breast after it has been stretched, the excess skin can be removed and rewrapped around the remaining breast tissue. The breast pyramid is then repositioned, moving the nipple to a more aesthetic level, and the breast tissue is rearranged, lifting and reshaping the breast.  This excisional and reshaping procedure tightens the skin envelop, compressing and firming the breast. 

With this compression, the breast gets smaller. If you have had dramatic weight loss and there is excess surrounding tissue in your bra roll area, this tissue can be used to restore volume that is lost with the compression of the breast lift procedure, augmenting the breast with your own tissue (see autoaugmentation of the breast with upper body lift). The bra roll tissue can be rolled in towards the breast to provide more volume to counteract the size reduction that accompanies every lift, giving more upper pole fullness, while at the same time, eliminating this fullness on the side of your chest. If your bra roll continues around the back, this entire roll can be repositioned from the back to the breasts, eliminating this roll circumferentially, resulting in tightening and lifting the back region, also known as an upper body lift.

Benefits of the Procedure

Have you lost all your pregnancy weight?  If you have not, and you proceed with surgery, the results of your surgery will be altered by the additional weight loss after surgery.  What was tight will loosen faster. Everything stretches out or relaxes over time. This process is accelerated with additional weight loss after surgery. What was lifted will droop over time as gravity always wins. Additional weight loss after surgery will speed this natural process.

The best results are obtained when you are happy with your weight. 

While exercise is good for muscle tone and overall conditioning, it will not tight the skin of the breasts. In fact, if you are aggressively exercising and losing weight, this will impact the appearance of your breasts. Remember, the breast is made of several components: the skin, the breast tissue and subcutaneous fat. Exercise affects the fat component, decreasing in amount with exercise and weight loss. This fat not only gives volume to the breast, but it also provides structural support. Thus, if you lose weight in your breasts, both volume and support decreases. If your skin cannot shrink along with the amount of volume lost, then there will also be excess skin. So know that it is best to have a stable weight before proceeding with breast surgery to provide you with the longest lasting results.

Is There a Specific Age that Benefits Most from a Breast Lift?

While any age patient can benefit from a breast lift, the best results are seen in patients with the best quality skin and muscle tone. If there are stretch marks that will be left after the surgery, then this tissue will relax and age faster. Thus, the better the quality of the remaining skin envelope of the breasts, the better the long-term quality of the result.

What About Pregnancy?

The breast lift is best performed after a patient is done with having children. Additional pregnancies after a breast lift will certainly affect the appearance of the operated breasts. Pregnancy will again lead to changes in the breasts, with stretching of the skin and soft tissues. Whether these will return to their pre-pregnancy state is unpredictable. Some may notice little or no change, however others may see some dramatic changes. If the patient is again left with laxity and additional volume changes in the breasts, then these changes might reach the level of you wanting additional surgery. Thus, to spare the added time and expense of a second surgery, it is best to wait until you are done with having children.

Breast Lift Addresses …

Deformity	Intervention	Benefit
Skin Excess	Skin Excision	Skin Tightening & Shape Improvement
Stretch Marks	Skin Excision	Remove Stretch Marks in Area Excised
Volume Deficiency	Add Volume	Volume Augmentation

Personal Consultation

Dr. Smith is a renowned body contouring specialist who has lectured locally, regionally, nationally, and internationally on breast and abdominal contouring surgery. He has over 18 years of clinical experience and has trained many plastic surgeons in the Greater Beverly Hills Area, surrounding region, and across the country in procedures such as the mommy makeover.

If you are interested in a breast lift with Dr. Smith, he will be pleased to meet with you to discuss your pregnancy and weight history as well as seek to understand your goals and desires. He will want to know about your personal and family history of breast disease as well as any surgeries you have had on your breasts. He will conduct a physical exam, focusing in on breasts, but will also look at your backside as well as this may impact your results and influence your options. He will then discuss your various options and recommend a treatment tailored to you and your goals and desires.

Preparation for Breast Lift

Doing all these will give you the best chance to have a great, uncomplicated surgical experience with the longest lasting best result possible for you.

What Happens During a Breast Lift?

This procedure is done under general anesthesia.  Before going to sleep, leg squeezers or sequential compression devices (SCDs)are placed on the calves to help decrease the chance of a blood clot or deep venous thrombosis (DVT).  Patients will also get a dose of antibiotics given in their IV to decrease the chance of a postoperative infection.

The skin excess is removed, the breast tissue is rearranged, repositioning the nipple complex and breast tissue into a higher position. The skin is closed in layers of dissolvable sutures and the closure is reinforced with skin glue and tape. A compressive surgical dressing is placed to help control the swelling.

Rapid Recovery

Once awoken from surgery, you will go to the Recovery Room for observation. Once you have met all milestones to leave, you may go home or to the floor for a 23-hour observation period.  If you go home, Dr. Smith likes to see you the next day to make sure all is well.

Pain Management

Narcotics:  You will be prescribed oral narcotics for moderate to severe postoperative pain.  You are also encouraged to take non-narcotic medications to help decrease the amount of narcotic consumed. Narcotics have more undesirable side effects that can be avoided with the use of non-narcotic pain medications.

Nausea Prevention

Medicine for nausea will be provided. Take if you need it. Take your medicines with a little food. This will also help decrease nausea associated with your medications.

Itching and Sleep

Some patients may experience itching associated with taking narcotics. If this is the case, Benadryl has been prescribed for you to help with this. If severe itching is noted, please contact Dr. Smith to evaluate you for a possible allergic reaction. Some patients will benefit from a gentle sleep aid in the early postoperative period. Benadryl can also be helpful to you in this regard.

DVT Prevention

While in bed, the SCDs should be worn. You are encouraged to be out of bed and walking at least once an hour. Both the SCDs and this ambulation will help decrease the chance of a blood clot or DVT. This can be a life-threatening complication. In some patients with enough risk factors for blood clots, some patients may get a blood thinner to minimize the chance of such a clot. This needs to be balanced with the risk of increased bleeding.

Antibiotics

These are not typically prescribed with a standard breast lift. You will not receive any additional antibiotics unless there is evidence of a postoperative infection. If an implant was used, then you will have antibiotics to be taken for at least one week. 

Nutrition

You are encouraged to advance to a normal diet, eating a good well-balanced diet, emphasizing your protein intake. Your nutritional requirements go up with the stress of surgery and you need the appropriate nutritional building blocks to heal. You are encouraged to consume 1.5 – 2.0 grams of protein for each kilo they weigh. For instance, if you weigh 60 kgs, then you should eat 90 – 120 g of protein each day. When patients are not appropriately healing their wounds, it is commonly traced to inadequate nutrition, specifically protein.

Drain Care

Drains are not typically used with a standard breast lift.

If an autoaugmentation is combined with your breast lift and a completion upper body lift of the back is performed, then there are drains that help evacuate fluid from the back. 

You need to record your 24-hour drain output for each individual drain. The bulbs must be collapsed at all times to create the suction necessary to facilitate good flow of fluid out into the bulbs. To more easily calculate 24-hour drain outputs, it is best to empty the drains at least once at the same time everyday. The drain may be emptied more frequently to ensure the bulb is always collapsed to create sufficient suction. Once the drain output has slowed to less than 30 cc in a 24-hour period, the drain is removed. Drain sites typically take a day or two to seal up. Once both drains are removed and both drain sites have sealed, you may shower. Until then, sponge baths are preferred.

Showers

For a standard breast lift, you are welcome to shower right away, but no submersion in a bath are allowed. 

If you have drains, Dr. Smith prefers you sponge bathe. Once the drains are out and the sites have sealed, then you are allowed to shower, but no soaking in the tub for 4-6 weeks, assuming normal healing.

Compressive Garments

Your surgical dressing may be removed postoperative day 1 and replaced with a lightly compressive sports bra that fastens in the front.  Most patients find the front-fastening garments more easy to get in and out of. There should be no underwire as this may put pressure on an incision in the lower portion of the breast.  The garment should provide light compression across the entire breast, helping to decrease tissue swelling or edema. This swelling can lead to more discomfort and also put stress on the freshly closed incisions.

Incision Management

The incisions are closed in multiple layers of dissolvable sutures and/or staples.  The incisions are sealed with a skin tape and glue combination. This typically stays in place for a month.  When showering, these should be patted dry. If the tape begins to lift, the lifted areas may be trimmed leaving the adherent tape in place. If there is moisture that is accumulating underneath the tape, this portion of tape should be removed to prevent maceration or incision break down due to moisture. Any tape and glue that is still in place at the one-month postoperative visit will be removed by Dr. Smith. 

Lifting

You should not lift anything greater than 10 pounds for 4-6 weeks assuming normal healing.  After all is sufficiently healed, Dr. Smith will allow you to gradually increase your activities to normal.