Many women, following the birth of their children, find that their breasts have drooped and lost both elasticity and volume. Some are unlucky enough to have developed low breasts from the start. Some have lost large amounts of weight leaving empty loose skin.
In a normal ‘average’ breast, the nipple is at the level of the midpoint of the upper arm and is above the level of the ‘crease’ under the breast. If the breast has been stretched by age, pregnancy, breastfeeding or weight gain, then the breast and the nipple will be at a lower level. Also in some, the nipple naturally points in a downward direction rather than forwards. Breast size also varies and may need adjusting.
Breast Uplift Surgery – Your Questions Answered
What is a mastopexy?
A mastopexy (breast uplift) lifts the breast to a position above the crease by removing skin under and around the nipple and positions the nipple facing directly forwards. If you pinch the skin of the lower part of the breast in front of the mirror you can see how the operation works.
After a breast uplift, the ‘size’ of the breast is the same as before since nothing is added or removed. It is common however for patients to think that the breast is smaller following an uplift because they don’t need such a large ‘cup size’ to cope with all the skin excess which tended to flop over the edge before the operation. In reality, the excess skin removed during an uplift operation only weighs a few grams.
In a breast augmentation, an implant is used to increase the size of the breast but this operation will not lift it. The breast will be at the same level. So if your bust is low, then having a breast augmentation will make it larger but it will still be low. The situation will be worse, not better. This is a common error.
If the problem is a bust which is both too low and too small, then it is necessary to do a combined procedure. A breast augmentation, inserting an implant to increase the size, is done at the same time as a mastopexy to lift the bust to a normal height. When the droop of the bust is mild or moderate this will work. But if the droop of the bust is very severe, then it is first necessary to lift the bust in one procedure, before an implant can be inserted at a second procedure.
Lastly, a breast reduction always involves an uplift as part of the operation. This uplift works because the breast is made smaller and so it will stay where it is positioned. But simply lifting a very large and heavy bust doesn’t work. The sheer weight will stretch the skin again and it will return to a lower disappointing level.
Your consultant will provide details on the procedures that could best meet your requirements.
What takes place during a breast uplift operation?
Breast uplift or mastopexy is performed when you are asleep under a general anaesthetic and requires a one night stay in hospital. The recovery time is two weeks.
Excess skin is removed from below and around the nipple-areola. The areola is usually made smaller as it is frequently too big. The lower breast tissue is lifted to a higher position on the chest wall and held with stitches deep under the surface. The nipple is also moved upwards. The skin edges, after removing the central skin excess below the nipple, are joined to make a vertical scar line passing down from the nipple to the crease under the breast.
A line may also be needed in the crease under the breast. The length of this line depends on how loose and low the breast is to start with. This line is kept as short as possible and in many cases, there is no line in the crease at all. So then the scar is just a ‘lollipop’ shape around the nipple and down.
Stitches are dissolving and dressings are very simple. At the end of the procedure, a long-acting local anaesthetic is used along the stitch lines so that when you wake up there is no major discomfort.
A mastopexy does not interfere with breastfeeding and hence can be considered before you have finished having children. A change in nipple sensation (i.e.e loss of sensation) can occur and the risk of this depends on how far the nipple is moved.
What is the recovery process like after breast uplift surgery?
After surgery, you will have some mild discomfort which is easily relieved by taking two mild pain killers such as paracetamol. Antibiotics are provided to minimize the risk of immediate infection.
You will have very light dressings after surgery. Drains, if present, will be removed the next morning. Stitches are dissolving so there is nothing on the surface and nothing to remove later.
You may shower straight away and it doesn’t matter if the stitch lines get wet. But don’t immerse in a bath until the wounds are healed. Immediately after the operation, it’s best to wear loose clothing. A sports bra will feel uncomfortable. A stretchy crop top is usually more comfortable. There may be bruising but this will disappear in about two weeks.
During the operation, the breasts are lifted as much as is possible. Often there is an ‘overcorrection’ which makes them look extremely high with the nipples pointing slightly downwards. This slowly settles down to leave the bust at the correct level.
You will be a bit tired for a few days after your surgery. You may drive after a week, but do not return to vigorous exercise for a month and it is not advisable to make any travel plans for at least one month after your operation.
The results of this operation are excellent restoring drooping breasts to a normal high position, with forward-facing nipples. Immediately after surgery, your new breasts will be apparent, but the final shape takes approximately 2 months to fully emerge.
Will my scars be obvious?
The scars, around the nipple then down to the crease under the breast, will look pleated immediately after surgery. This is part of the technique of the operation to gather the skin and these irregularities take 6 weeks to flatten. In rare cases, those with very fair skin can suffer hypertrophic or ‘bubbly’ scars mainly around the nipple-areola. If this happens it may be necessary to ‘revise’ these unsatisfactory scars many months later. The chances of this problem happening again are then much less. If they do recur then short-acting steroid injections are used.
The scars will not be visible when you wear low-cut tops, bikinis and bras. Over the next twelve months, most scars will fade into your natural skin tone.
Is it very painful?
A breast uplift procedure involves surgery so initially, there will be swelling and soreness at the operation site. However, you will be prescribed medication to help relieve tenderness and there shouldn’t be any severe pain.
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