Breasts constitute an important part of a woman’s femininity. Shape, size, and firmness have an impact on how a woman feels, dresses and behaves, on her personal life and broader social environment. Droopy breasts can make a woman feel self-conscious and limit her ability to wear desirable clothes. Breast reshaping helps a woman feel more proportionate. Dr. Motakis views breast surgery as a balancing procedure. With any breast procedure, his goal is to offer his patients symmetric, proportionate, lifted breasts that look natural. Upon a thorough discussion, Dr. Motakis will determine the procedure, which is most appropriate for you.
What is a breast lift?
A breast lift — also known as mastopexy — is a surgical procedure performed by a plastic surgeon to change the shape of your breasts and make them appear firmer and more lifted. During a breast lift, excess skin is removed, the nipple and areola are lifted, and the breast tissue is reshaped to raise the breasts. You might choose to have a breast lift if your breasts sag or your nipples point downward. A breast lift by itself won’t significantly change the size of your breasts. However, a breast lift can be done in combination with breast augmentation using a breast implant (augmentation mastopexy) or in combination with a breast reduction. In cases where the breasts are different sizes, a mastopexy can help balance them and make them the same shape and size.
Who is a good candidate for a breast lift?
Most adult women in good health who have some degree of sagging around their breasts are good candidates for this procedure. Breast lifts can be performed on women with breasts of all sizes, but if you have heavy breasts, breast reduction and lift may be a better option. On the other hand, if the breasts are small, an implant can be used at the same time as the lift to optimize breast size. Women who feel that their breasts have no shape, their breasts appear elongated and flat with the nipples pointing somewhat downwards, who’s skin is stretched, or who’s areolas appear excessively large or who have one breast sitting lower than the other are likely good candidates for a breast lift. Smoking can interfere with healing, so it is important to stop smoking 4 weeks before this procedure and only resume 2 weeks after. Lastly, if you are planning to lose a significant amount of weight, it is best to have your breasts lifted once you have reached your goal weight and your weight has stabilized.
Depending on the degree of breast sagging different techniques may be used to optimize the shape of your breasts. These include:
- Lifting the nipple through an incision around the areola (peri-areolar mastopexy). This technique is usually reserved for minor lifts and is usually best when combined with a breast implant.
- Using incisions around the areola and down the middle of the lower breast (lollipop or vertical mastopexy).
- Using an anchor scar with looks like the lollipop but has an additional horizontal incision along the lower crease of the breast (wise pattern or anchor mastopexy). This technique is necessary in cases of severe droop where the vertical skin excess is too extensive.
The decision of which technique to use is based on the breast shape and size, the position and size of the areolas, the degree of breast sagging, the elasticity and quality of the breast skin, as well as, on whether an implant will be used at the same time as the lift.
The procedure takes 2-3 hours to perform. During the procedure, the breast tissue is exposed, lifted and re-shaped to create a firmer and tighter looking breast. The nipple is repositioned to its ideal higher position and when necessary the areola is decreased to its ideal diameter. Lastly, the excess skin is removed in order to create a tighter and firmer looking breast. If implants are used during breast lift surgery, they are inserted beneath the natural breast tissue or the muscle of the chest (pectoralis) through the same incision used for the lift. The breast tissue and muscle are lifted, and the implant is inserted inside the precise pocket created. Then the pocket is closed using internal sutures and the breast tissue is reshaped around the new augmented breast. All sutures used during the procedure are internal and usually, there are no drains used. Surgical tape is then applied over all incisions and bandages are applied. This makes recovery easier and scarring optimal. The bandages stay intact over the first postoperative week. A supportive compressive bra is applied after the procedure to minimize swelling.
What is the recovery period after a breast lift?
Recovery after surgery takes 1-2 weeks during which a supportive compression bra is worn. Specific dressings will be applied after your surgery and they will stay intact until your follow up visit one week after surgery. You will be able to shower the next day after the procedure as Dr. Motakis does not usually use drains with this procedure. Your breasts will be slightly swollen and may feel slightly sore, but when needed, you will feel comfortable with the use of mild analgesics. If implants are used, you will be required to take antibiotics for a week. You’ll need to take it easy for a few days after surgery. After one week, you should be able to return to work, but you will need to limit intense physical activity such as going to the gym for 3-4 weeks. At your one week follow up appointment your bandages will be changed, the incisions inspected, and a special tape applied to expedite healing and reduce scarring. There are no sutures that need to be removed with breast lift surgery, as Dr. Motakis uses only internal dissolving sutures in order to minimize scarring and decrease patient discomfort.
What are the risk factors of a breast lift?
Complications of a breast lift include unfavorable healing or scarring, change in skin or nipple sensation and infection and asymmetry, among others. However, these seldom occur. If an implant is used capsular contracture, rupture or deflation, rippling, re-operation, and implant removal or exchange are the most frequent risks, similar to breast augmentation. Capsular contracture is scar tissue that distorts the shape of the breast implant. It can present at any time after surgery, and it may require the removal of the scar tissue and the insertion of new implants. Dr. Motakis will discuss all risks in detail during your consultation and pre-operative appointments. Correcting these complications might require more surgery, sometimes requiring to either to remove or replace the implants.
In recent years, the use of implants with a textured surface has been associated with the occurrence of a disease known as Anaplastic Large Cell Lymphoma (ALCL). The incidence of ALCL with an implant is lower than 1/3,000. ALCL is not seen with smooth implants. Dr. Motakis only uses smooth implants which pose no risk of ALCL.
Are there any alternatives to breast lift?
In some cases where the sagging of the breast is minimal, a breast augmentation alone can result in a more lifted breast. In some isolated cases the use of fat grafting can also help lift the breast, however, the resulting size, in this case, may be somewhat unpredictable. Dr. Motakis will discuss with you all options available during consultation. However, when the breast becomes too droopy, there are no good alternatives to a proper breast lift.
Can a breast lift be combined with other procedures?
A breast lift can be combined with various other procedures such as an augmentation (augmentation mastopexy), fat grafting, liposuction of the axillae and the arms or any other areas or a tummy tuck (see mommy makeover surgery) among others.