With time and pregnancies, women's breasts can lose some of their firmness and fullness–and, like many areas of the body, they begin to give way to gravity.
A breast lift (mastopexy) raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour. After a mastopexy, the breasts are higher on the chest and firmer to the touch. Breast lifts can also reposition and reduce the size of the areola—the dark skin surrounding the nipple—which may have stretched or drooped.
Breast lifts alone, however, do not add volume to breasts. For this reason, a breast lift is often conducted in conjunction with breast augmentation surgery, since the loss of the skin elasticity often results in a significant loss in the breast tissue as well. That is, lifted breasts may need added volume from silicone or saline implants, or from fat transfer, to achieve a full, voluptuous appearance.
Your Breast Lift Consultation
During your consultation, Dr. Karlinsky and you will discuss your goals for breast lift surgery, as well as whether breast augmentation is also appropriate. If so, Dr. Karlinsky will help you determine which implants to use (silicone or saline), or whether fat transfer may offer the right level of volume to your bust. Most importantly, Dr. Karlinsky will inform you about potential risks and complications. Women planning to have children are advised to postpone surgery, since pregnancy and nursing can counteract a breast lift's effects by stretching the skin.
How is Breast Lift Surgery Done?
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. There are several types of incision methods that can be used when performing a breast lift. The technique Dr. Karlinsky chooses depends on the patient's:
- Breast size and shape
- Degree of sagging
- Size and position of the areolas/nipples
- Amount of excess skin
- Skin quality
- And other factors.
The three most common incision types are two rings around the areola in a doughnut shape (small-incision mastopexy, generally only recommended for patients with small breasts and minimal sagging); around the areola and down to the breast crease in a lollipop shape; and the lollipop with an additional half-moon incision along the breast crease, in an anchor shape.
Beginning with administration of anesthesia or IV sedation, Dr. Karlinsky makes the necessary incisions, and then lifts and reshapes the breast tissue into its new, rejuvenated contour. She moves the nipple and areola higher on the breast and removes extra skin around the perimeter if the areola is enlarged. Finally, Dr. Karlinsky trims the excess breast skin that resulted from poor elasticity. Stitches layered deep throughout the breast tissue support the lifted breasts.
When the mastopexy is complete, the skin is closed with stitches, tissue adhesive and/or surgical tape. Some of the incisions are hidden in the breast crease. Others will be visible.
After surgery, the breasts are wrapped with gauze dressings, and you may need to wear an elastic bandage or a surgical bra. After a few days, this is replaced with a soft support bra, which is worn 24 hours a day for about a month.
The breasts will probably be bruised, swollen, and uncomfortable after surgery, but this will pass in a few days. Any numbness in the breasts and nipples should lessen as swelling subsides. Stitches are removed after one to two weeks, and many patients return to work then. All scars will mature with time.
Breast Lift and Augmentation Surgery: The Details
This operation itself takes slightly longer then a breast lift alone, and generally patients experience a bit more discomfort since almost all implants are placed under the pectoralis muscle. But as with any other breast procedure, this operation will not prevent you from getting back into your normal life within 48 to 72 hours after surgery.
Other then heavy lifting and running for 10 days after the procedure, Dr. Karlinsky places no restrictions on her patients postoperatively. Most women are able to wear any kind of bra they like 7-10 days after surgery, including an underwire bra.