Breast uplift (mastopexy)

At the consultation, your surgeon will assess your wishes, identify any existing asymmetry of the breasts or underlying ribcage and exclude the presence of breast lumps. Your general health and your propensity to good scar formation will be established. The procedure will be explained.

Bring a new, well shaped, good fitting and supportive sports bra’ to hospital when you are admitted. The size and fit can be checked. Please read and observe all the recommendations provided to you. These precautions greatly reduce the risks of complications. In particular, you must not smoke in the preceding six weeks or in the six weeks after the operation. The risk of complications is markedly increased by smoking.

If possible, ensure that your weight is as close to your desired weight as possible. If you lose weight after the operation this may cause loss of firmness in the breast.

Remember not to use bath oil or moisturizer after bathing before your surgery as this can interfere with the durability of the reference points which will be marked on your skin just before you go for surgery.

Those important guide points will be marked on your breast skin prior to your anaesthetic to indicate the new position of the nipple and to guide the surgeon as to the amount of redundant skin requiring removal.

The operation is under general anaesthetic and will last about three hours. Although the nipple areolar complex will be repositioned, this is done by trimming the surrounding skin and it remains securely attached to your underlying breast throughout. The skin is incised along the carefully designed pattern and elevated off the breast tissue. The excess skin is removed leaving behind what is in effect a close fitting skin bra’. If your areola has stretched and is too large it can be re-sized to more appropriate dimensions.

The remaining skin is now re-draped over and around the breast tissue and sutured snuggly to form a pert new breast mound. The skin closures will be circular around the nipple-areola with a vertical join descending from the areola to meet a transverse suture line tucked in the crease below the breast.

Temporary surgical tube drains will be in place when you awake. These minimise the bruising and risk of infection from the accumulation of blood and serum beneath the elevated skin flaps.

You will probably remain in hospital for one night. While there will be some discomfort, this will usually respond to moderate analgesics such as paracetamol. The drain tubes will usually be removed before you go home.

Your breasts will be supported in a dressing which should remain dry and clean until it is removed at your follow-up visit in one week. Until the stitch lines are dry and healed, take shallow baths rather than showers. Most of the stitches will be below the surface and will dissolve. Some may need to be removed at this visit or a subsequent one. Bring your new sports bra to these follow-up appointments so that it may be fitted at the earliest opportunity. You will be required to wear it day and night for 6 weeks.

You are encouraged to remain mobile in the weeks following surgery but physical exercise, including heavy housework (particularly vacuuming and ironing), dog walking and the repeated lifting of heavy objects should avoided for the first three weeks. Strenuous exercise such as jogging, exercise classes, gym workouts and heavy housework should be avoided for 6 weeks. Healing tissues benefit from rest and need to heal strongly before they are stressed.

As soon as the wounds are no longer being taped, start to massage the scars with a cream provided by BPS and continue this until they begin to fade. In the first year avoid exposing the new scars to sunlight and continue to use sunblock thereafter.

Depending on your occupation, you may return to work after two weeks but the limitations on physical activity apply. Driving is not advised for 2 weeks and your motor insurance may be invalid if you drive in that period.

There will be some colourful bruising of the breast and chest skin usually lasting about 3 weeks.

It is unusual to lose sensation in the nipple following a mastopexy or breast lift and any changes in sensation should recover in the following months. There will be some numbness of the skin over the breast.

Great care is taken in the planning and assessment stages to identify any existing significant asymmetry in the breasts. Some difference in breast size is quite normal and, in the drooping breast, often unnoticed. Despite careful planning, and because of the mobile nature of the breasts and the stretchy skin, some asymmetry of size and shape may develop. The tissues of the breast and it’s overlying skin have proven their capacity to stretch and to a variable degree this can continue after a breast lift. In a few, more pronounced cases, this will require a further, longer lasting, tightening of the skin. This will have cost implications.

The pattern of the scarring following a mastopexy can in a few cases be limited to a discreet scar around the nipple areola. More commonly this will be extended by a vertical scar descending from the 6 o’clock position to the crease below the breast. There, depending on the extent of the skin removal required, a transverse scar will be extended in the crease below the breast in the so called ‘inverted T’ pattern.

Many patients are fortunate to form thin hair line scars which fade quite quickly. In others the speed of “scar maturation”, as it is called, is slower and a few can form red raised and itchy scars which take much longer to settle. If you think you have this tendency please notify your surgeon. You should anticipate that scar improvement may continue for up to 18 months.

When breasts are very droopy, the improvement following mastopexy in the hands of an experienced cosmetic plastic surgeon can be dramatic. You can always expect to feel much more positive about your breast shape.

There will be scarring and it is wise to discuss this with your partner prior to proceeding.

The natural changes occurring in your breasts are not arrested by mastopexy and any decrease in breast volume may be progressive. It is sometimes necessary to consider both breast augmentation and mastopexy. It may be possible to combine these procedures but they are often performed separately to ensure the best outcome.

If the precautions to avoid smoking and aspirin like drugs are observed, the risk of bleeding and the need to evacuate a blood clot is low. Infection and delayed healing and therefore increased scarring is also fortunately uncommon.

There is always a small risk of developing fat necrosis especially if the operation is more extensive and if breast tissue is removed to achieve improved symmetry. Fat necrosis occurs in prone individuals when a small area of fat responds to surgery by changing in character to form a firm lump which may take many months to resolve. The lump appears to have diminished blood supply and it can develop flecks of calcification leading to confusion at mammography examinations.