Breast Lift - Is this the correct procedure for you
Article by Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
Throughout the centuries, women who were unhappy with the size andshape of their breasts had little choice but to try to disguise the problem. Aswith the rest of our bodies, gravity continues to exert its constant downwardforce on the breasts. This force when exerted on breast skin that has begunto loose its elasticity, causes the breast to sag. The mastopexy or breast liftoperation is done to restore a youthful, uplifted appearance to the breasts. With continued sagging the nipple may drop from its youthful placement toa position that is below the breast fold. The surgery to uplift the breastremoves no breast tissue. Only excess skin is removed and the nipplerepositioned to create an improved shape and contour. The volume of thebreast will remain the same, thus this is the ideal operation for a womanwho is satisfied with her breast volume, but dissatisfied with the shape andcontour of the breast. In some cases it may be necessary to increase the sizeof the breast with an implant at the time of the breast lift. Breast sagging can occur naturally or as the result of pregnancy and breastfeeding. The problem is one of loss of breast volume coupled with loss ofskin elasticity. Breast sagging or Ptosis is classified into three categories. Minor sagging occurs when the nipple is at the level of the fold beneath thebreast but above the contour of the breast itself. Moderate ptosis means thenipple is below the crease but still above the contour of the breast. Severeptosis occurs when the nipple is below the fold of the breast.
The Surgical Technique of a Breast Lift
A breast lift procedure can be done in either our office operating suite orin the outpatient area of the hospital. It is typically done under eithertwilight anesthesia (local anesthesia with sedation) or under generalanesthesia. When the procedure is performed in the office, we have acertified registered nurse anesthetist present to administer the anesthesiamedications.
The breast lift patient will commonly have a normal sized breast and in thiscase all that is required is a lifting of the sagging breast. The procedure isaccomplished by changing the position of the nipple-areola complex. Thenipple and the dark circle of skin around it are brought up to a morenormal position on the chest wall. The incisions usually follow the naturalcurve of the breast and are usually located in the crease under the breast. The incisions typically look like a key hole and this is made in the areaabove the nipple to mark the new position for the nipple and areola. Through a combination of vertical and horizontal incisions the excess’skinis removed from the lower section of the breast. Then the nipple, areola andbreast tissue are move up to there higher and more normal position. Afterthe nipples are relocated the upper skin flaps are brought down andwrapped around and brought together to reshape a new breast. If thesagging is only minimal or moderate a procedure with less incisions andscars may be possible. This can sometimes be done removing skin fromaround the areola and drawing it towards the center portion of the breast. If there is a problem with breast volume we may recommend the insertionof an implant in addition to the breast lift. There will be scars as a result ofthe procedure. The incisions are placed in a position that are thought to bethe least noticeable. Everyone heals differently and usually the scars will bequite inconspicuous. The scars will be expected to go from pink and firm tosoft and faded over a six to twelve months period. The operation can be performed in our in-office surgical suite or in theoutpatient area of the hospital. The normal recovery time is very short. Many women can have their breast lift done on a Friday and be back towork Monday. Some soreness is expected to last for the first week or so.
Strenuous physical activity such as jogging and aerobics will be restricted during the first four weeks. You will be allowed to take a shower on the day following the operation. Pain medication is usually needed only for the first couple of days following the surgery. This is discussed further in the section on Post-operative instructions.