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Mastopexy (Breast Lift)
Health Guide
If You Are Reconsidering A Breast Lift

Over the years, factors such as pregnancy, nursing and the force of gravity take their toll on a woman's breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. Breast lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts - at least for a time. (No surgery can permanently delay the effects of gravity). Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. If your breasts are small or have lost volume - for example after pregnancy - breast implants inserted in conjunction with mastopexy can increase both their firmness and their size. If you're considering a breast lift, this pamphlet with give you a basic understanding of the procedure - when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask your doctor if there is anything about the procedure you don't understand.

The Best Candidates for Breast Lift

A breast lift can enhance your appearance and your self confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

The best candidates for mastopexy are healthy, emotionally stable women who are realistic about what the surgery can accomplish. The best results are usually achieved in women with small, sagging breasts. Breasts of any size can be lifted, but the results may not last as long in heavy breasts.

Many women seek mastopexy because pregnancy and nursing have left them with stretched skin and less volume in their breasts. However, if you're planning to have more children, it may be a good idea to postpone your breast lift. While there are no special risks that affect future pregnancies (for example, mastopexy usually doesn't interfere with breast-feeding), pregnancy is likely to stretch your breasts again and offset the results of the procedure.

All Surgery Carries Some Uncertainty And Risk

A breast lift is not a simple operation, but is normally safe when performed by a qualified surgeon. Nevertheless, as with any surgery, there is always a possibility of complications or a reaction to the anaesthesia. Bleeding and infection following a breast lift are uncommon, but they can cause scars to widen. You can reduce your risks by closely following your physician's advice both before and after surgery.

Mastopexy does leave noticeable, permanent scars, although they'll be covered by your bra or bathing suit. (Poor healing and wider scars are more common in smokers). The procedure can also leave you with unevenly positioned nipples, or a permanent loss of feeling in your nipples or breasts.

Planning Your Surgery

In your initial consultation, it's important to discuss your expectations frankly with your surgeon, and to listen to his or her opinion. Every patient - and every physician, as well - has a different view of what is a desirable size and shape for breasts.

The surgeon will examine your breasts and measure them while you're sitting or standing. He or she will discuss the variables that may affect the procedure - such as your age, the size and shape of your breasts, and the condition of your skin - and whether an implant is advisable. You should also discuss where the nipple and areola will be positioned: they'll be moved higher during the procedure, and should be approximately even with the crease beneath the breast.

Your surgeon should describe the procedure in detail, explaining its risk and limitations and making sure you understand the scarring that will result. He or she should also explain the anaesthesia to be used, the type of facility where the surgery will be perforPreparing For Your Surgery

Depending on your age and family history, your surgeon may require you to have a mammogram (breast x-ray) before surgery. You'll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking and taking or avoiding certain vitamins and medications.
While you're making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.

Where Your Surgery Will Be Performed

Your breast lift may be performed in a hospital, an outpatient surgery centre, or a surgeon's office-based facility. It's usually done on an outpatient basis, for cost containment and convenience. If you're admitted to the hospital as an in-patient, you can expect to stay one or two days.

Types of anaesthesia

Breast lifts are usually performed under general anaesthesia, which means you'll sleep through the operation.

In selected patients - particularly when a smaller incision is being made - the surgeon may use local anaesthesia, combined with a sedative to make you drowsy. You'll be awake but relaxed, and will feel minimal discomfort.

The Surgery

Mastopexy usually takes one and a half to three and a half hours. Techniques vary, but the most common procedure involves an anchor-shaped incision following the natural contour of the breast.

The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola are moved to the higher position. The skin surrounding the areola is then brought down and together to reshape the breast. Stitches are usually located around the areola, in a vertical line extending downwards from the nipple area, and along the lower crease of the breast.

Some patients, especially those with relatively small breasts and minimal sagging, may be candidates for modified procedures requiringx less extensive incisions. One such procedure is the "doughnut (or concentric) mastopexy" in which circular incisions are made around the areola, and a doughnut-shaped area of skin is removed.
If you're having an implant inserted along with your breast lift, it will be placed in a pocket directly under the bra tissue, or deeper, under the muscle of the chest wall.

After Your Surgery

After surgery, you'll wear an elastic bandage or a surgical bra over gauze dressings. Your breasts will be bruised, swollen and uncomfortable for a day or two, but the pain shouldn't be severe. Any discomfort you do feel can be relieved with medications prescribed by your surgeon.

Within a few days, the bandages or surgical bra will be replaced by a soft support bra. You'll need to wear this bra around the clock for three to four weeks, over a layer of gauze. The stitches will be removed after a week or two.

If your breast skin is very dry following surgery, you can apply a moisturiser several times a day. Be careful not to tug at your skin in the process, and keep the moisturiser away from the suture areas.

You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This numbness usually fades as the swelling subsides over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.

Getting Back To Normal

Healing is a gradual process. Although you may be up and about in a day or two, don't plan on returning to work for a week or more, depending on how you feel. And avoid lifting anything over your head for three to four weeks. If you have any unusual symptoms, don't hesitate to call your surgeon.

Your surgeon will give you detailed instructions for resuming your normal activities. You may be instructed to avoid sex for a week or more, and to avoid strenuous sports for about a month. After that, you can resLink to St Marks Breast Centre Online

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