Breast lift, or mastopexy, is a surgical procedure to raise and recontour sagging breasts. In some cases, it can be performed in conjunction with surgery to enlarge the size of the breasts with breast implants.

A consultation with a plastic surgeon is the first step an individual should take it considering inastopexy. You should discuss candidly your expectations about looking and feeling better after surgery, while keeping in mind that the desired result is improvement, not perfection.

We will conduct a routine breast examination and, depending on your age and family history, may determine that mammograms, or breast x-rays, are required. After examining you, we will discuss other variables that influence the decisions involved in the procedure, such as your age, the size and shape ot your breasts and the condition of breast skin. A patient considering breast-feeding following mastopexy should discuss the matter with us at this time.

During the initial visit, we will explain the specific details of your case, including the surgical technique to be used, the anesthesia, where the operation will be performed and what the surgery realistically can accomplish.

Thousands of breast lifts are performed successfully each year. Nevertheless, you should be aware of the potential risks of surgery and specific complications associated with mastopexy. Postoperative complications such as infection or blood clots are rare. Poor healing may necessitate subsequent scar revision. Smokers should be made aware that nicotine can delay healing. Risk of complications can be minimized by closely adher­ing to your surgeon's advice on follow-up care.

The Surgical Procedure
Mastopexy typically is performed to lift sagging, loose breasts or breasts that have lost volume and elasticity after childbearing. It also can reduce the size of the areola, the dark pink skin surrounding the nipple. (Fig. I) The extent of the procedure depends on what changes are desired and what we deem appropriate.

Mastopexy usually is performed under general anesthesia, although local anesthesia may be used in particular cases.

In the operation a keyhole-shaped incision is made above the areola to define the new location for the nipple. Working through incisions, excess is removed skin from the the breast. The nipple, areola and underlying breast tissue are moved up to a new higher position, after the nipple is relocated, flaps of skin formerly above and to the sides of the nipple are brought down, around and together to reshape the breast. (Fig.3) Sutures close the wounds under the breast and around the nipple area. In patients with only minimal sagging, a modified procedure may be used to excise only skin from the large areola and the area immediately surrounding it. When breast augmentation is performed in conjunction with the lift, a breast implant, is placed, in a pocket created either directly under the breast tissue or underneath the chest wall muscle. The prosthesis is a flexible plastic envelope that contains a silicone gel. (Fig. 2). Following surgery, a bulky gauze dressing is wrapped around the breasts, or the patient may be placed in a surgical bra.

Depending on the extent of the surgery, the procedure usually lasts about two hours.

Postoperative Recovery
After surgery, pain that is controlled easily by medication will subside in a day or two. If you have been operated in a hospital, you will be released in the same day. Within the first week, the dressing will be replaced by a soft bra which you will be advised to wear for several weeks.

Swelling and discoloration around the incisions generally will subside in a few days. After surgery, there may be temporary loss of sensation in the nipples and breast skin. If it occurs, this condition will improve with time. Sutures will be removed within two weeks of surgery.

The objective of mastopexy is higher, well-contoured breasts. (Fig.4) Although we make every effort to keep scars as inconspicuous as possible, mastopexy scars are permanent. They often remain highly visible for a year following surgery, then fade to some degree. However, since incisions are made around and below the nipples, scars should not be noticeable even in low-cut clothing.

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