Candidates for Surgery
Candidates for Breast Lift (Mastopexy) surgery are women who have sagging breasts due to past pregnancies, genetics, or aging. Often times the sagging is too great to be treated by implants alone. Women with asymmetric or enlarged nipples or areolae (pigmented areas around nipples) are candidates for a breast lift.
A mastopexy or breast lift operation is designed to improve the shape and position of the breast without reducing their size. It is used for breasts which sag or droop (ptosis). Sagging of the breasts may occur with normal development for some women, or as part of the aging process. Pregnancy, breast-feeding and weight loss are other conditions which increase breast ptosis. Some patients will have a better shape to their breast such as increased superior fullness if an implant is used at the time of mastopexy. The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height.
Dr. Nichter and Dr. Horowitz use a short scar technique, “lollipop scar” or “donut lift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.
The procedure is done on an outpatient basis under intravenous sedation and local or general anesthesia. As mentioned above there are a variety of techniques for these operations. Most commonly there is an incision around the areola, with or without a vertical incision on the lower part of the breast (donut, vertical or “lollipop” techniques). Although the “anchor-shape” or inverted “T” incision is still more popular in the United States, it represents an older technique with extensive scarring and a less optimal result in many cases. These new techniques are utilized in the vast majority of cases, the rare exception being extremely large breasts. The nipple-areola complex is repositioned higher, the excess skin is removed, and the breast is reshaped in a pleasing contour and in a more normal position. The insertion of an implant as well, may be advisable to restore superior fullness which is lost with aging and after pregnancy despite the rest of the breast being overly large.
The patient will go home in a bra or with only light dressings over the incision lines.
Sutures are dissolvable but the ending knot is removed within 1-2 weeks.
Initial discomfort is easily controlled with oral medication. Light activities may be started in 7-10 days.
Risks of Surgery
Over time, gravity will continue to have an effect and the breast skin will tend to stretch. The degree of stretching and sagging varies between women: generally, women with smaller breasts experience less recurring sagging. If sagging does occur, further excision of the skin on an outpatient basis can be used to correct the problem. Heavy and large breasts may lead to recurrent sagging and may require the removal of a small amount of breast tissue to achieve an optimal shape and size. One key to a satisfying result is realistic expectations.
All surgical procedures carry some degree of risk. Occasionally, minor complications occur and do not affect the surgical outcome. Major complications associated with this procedure are rare. The suitability of the breast lift procedure and specific risks may be determined during a consultation with Dr. Nichter or Dr. Horowitz.