Breast lift (Mastopexy)

Mastopexy or breast uplift surgery is a cosmetic surgical procedure that is performed to reshape and elevate loose and sagging breasts. Breasts often lose their elasticity, shape and firmness with age, or after pregnancy and weight gain/loss. In this procedure, the surgeon will remove the excess skin, tighten the nearby tissues and may alter the position of the nipples to improve the shape of the breasts. The surgery can reshape breasts of any size; however, women with large breasts may have to opt for breast reduction as the results on large breasts are not long term.

Read more: Loose or saggy breasts causes and tips to tighten your breasts 

Breast lift surgery is not performed for medical reasons. An individual may choose to undergo this surgery if they are unhappy with the shape, firmness and volume of their breasts or if their breasts are sagging due to causes such as weight loss. Men with gynecomastia can also undergo mastopexy to correct the shape of their breast/chest.

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Women who plan to have a child in the future should not undergo this surgery since pregnancy can affect the shape of the breasts and, thus, the results of this surgery. Additionally, your doctor may ask you to push the surgery to a later date if you have plans for weight loss or are breastfeeding a child.

You will be asked to get a mammogram and x-ray of breast to assess the risk of breast cancer. The imaging tests also help to detect any changes in the breast tissue after the surgery. Some basic laboratory tests may also be advised for evaluation of your health.. 

The surgeon may also give you the following instructions:

• You will be asked to share a list of all your current and previous medicines, such as prescription, herbs, supplements and over-the-counter drugs.
• You may have to discontinue blood-thinning medicines such as aspirin, warfarin, ibuprofen, two weeks before the surgery if you are taking them.
• Your doctor will also suggest you to discontinue certain herbal supplements that can increase bleeding during surgery.
• A list of drugs that you can take on the day of the surgery will be provided to you or you may be advised to take certain medicines before the surgery.

Other precautions you may be asked to take before the surgery are as follows:

• Inform the surgeon about your pregnancy status.
• Stop smoking at least 7-14 days before the surgery as smoking can prolong your recovery period.
• You may be asked to fast before the surgery.
• Wear loose, comfortable clothes that have zip or buttons in the front.
• Reach the hospital for the surgery at the scheduled time.

Arrange a friend, family member or a responsible adult to drive you to and from the hospital.

After admission to the hospital, you will be asked to remove your clothes and wear a hospital gown. You will be asked to sign a consent form to give permission for the surgery. The surgery usually involves the following steps:

• An anaesthesiologist will administer general anaesthesia to you. It is a medicine that puts you into a deep sleep so that you do not feel any pain during the surgery.
• After you are completely unconscious, the surgeon will place one of the following three types of incisions (cuts) on your breast based on the requirement:
  • A cut encircling the areola
  • A cut encircling the areola with another vertical cut from the nipple to the breast line
  • A cut encircling the areola and vertically down to the breast line along with a horizontal cut along the breast line.
• Following the incisions, the surgeon will remove the underlying extra tissue and re-position your nipple and areola.
• If the areola is enlarged, then the surgeon may remove some skin from it too. The surgeon may also remove surplus breast skin to compensate for the loss of elasticity.
• Finally, he/she will close the incision with skin adhesives, sutures and/or surgical tapes.

It is normal to experience bruising, pain, swelling, redness and a loss of sensation at the surgical site after you are discharged from the hospital. These symptoms often fade with time.

However, the surgeon may prescribe painkillers to provide relief from the discomfirt. He/she will also advise you to take short walks after the surgery and in the recovery period to promote blood flow in your body. Additionally, you may be shown and taught a few massaging techniques for your breasts and special exercises to assist in the healing process.

The surgeon may instruct you to restrict the following during the recovery period:

• Strenuous activities: You must avoid strenuous activities such as heavy lifting for three to six weeks since hard work can increase your blood pressure and risk of bleeding.
• Driving: You should not drive for at least two weeks after the surgery or until your surgeon allows you to do so.
• Work: The surgeon may allow you to resume work only after one to two weeks after the surgery as per your condition.

You can take care of your wound by following the instructions provided below:

• Ensure that the surgical area is dry, clean and covered.
• Take a shower or bath only after removal of the drainage tubes from the breasts. Until then, avoid swimming or soaking in a hot tub.
• Since the scars may take about a year to fade away, you should protect the area by applying appropriate sunscreens, preferably SPF 30 and higher.
• Avoid smoking during the recovery period because it can increase the chances of infection and complications post-surgery. Similarly, you should also avoid alcohol usage.
• It is essential to eat healthy foods, including fruits and vegetables during the recovery period to reduce the risk of infections and promote smooth bowel movements.

Mastopexy improves the shapes of breasts, makes you feel better about your appearance and increases your self-confidence. The results of the surgery can be observed immediately after the surgery. Most importantly, you should have realistic expectations from the surgery, that is, improvement in the shape of the breasts and not perfection.

When to see the doctor?

You should call the surgeon if you experience any of the following symptoms after the surgery:

• Fever with a temperature of ≥100°F
• Increased pain, swelling, bruising or redness at the surgical area
• Bleeding or yellow/green drainage at the incision site
• Numbness
• Nausea or vomiting
• Rashes
• Headache
• Sudden swelling of the breasts

The risks and complications associated with this surgery are as follows:

• Emergence of lumps in the breasts
• The accumulation of blood inside breasts
• Loss of sensation in the outer area of breasts
• Loss of skin from the nipples and areola
• Continued pain in breasts
• A reduced ability to breastfeed
• Cosmetic problems such as: 
  • Uneven positions of the nipples
  • Uneven size of the breasts, that is, one breast is larger than the other
• General complications like bleeding, emergence of blood clots in the legs and the lungs, excess scarring at the operated skin and infection
• Risks of general anaesthesia that can occur are breathing problems, reaction to medicines, bleeding and formation of blood clots.

The surgeon will ask you to visit the hospital after a few days of the surgery to remove the drainage tubes inserted in your breasts. Stitches, if present, will be removed during a follow-up appointment two weeks after the surgery.

Disclaimer: The above information is provided purely from an educational point of view and is in no way a substitute for medical advice by a qualified doctor.