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Summary

Mastopexy is a cosmetic surgery that is aimed at uplifting and improving the shape/appearance of your breasts. Breasts usually lose their youthful appearance and firmness with age, after pregnancy or with weight gain/loss programmes. This surgery improves the shape of the breasts by removing extra skin and tissues from breasts. Mastopexy may also be done in men for gynaecomastia (enlargement of breasts) or after weight loss.

You will be put into a deep sleep (you will be given anaesthesia) during the surgery so that you do not feel any pain. The procedure is usually completed in about 90 minutes to 2 hours. The results can be immediately observed after the surgery.

Women will need to wear a surgical bra for several weeks after the procedure, to support their breasts as they heal. The scars usually take about a year to fade away. The surgeon may instruct you to restrict your physical activities during the recovery period, and you may be asked to rest for about one to two weeks before resuming work. Women should not undergo this surgery if they are breastfeeding or are planning to have a child in the future.

  1. What is breat lift (mastopexy)?
  2. Why is breast lift (mastopexy) recommended?
  3. Who can and cannot get a breast lift (mastopexy) done?
  4. What preparations are needed before a breast lift (mastopexy)?
  5. How is breast lift (mastopexy) done?
  6. How to care for yourself after breast lift (mastopexy)?
  7. What are the possible complications/risks of breast lift (mastopexy)?
  8. When to follow up with your doctor after a 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.

In men, mastopexy is done along with breast reduction. In this surgery an incision (cut) is made around the areola through which excess tissue is removed by liposuction or cutting it out or a combination of both. A drain is placed and the incision around the areola is closed in layers taking care to distribute the excess skin evenly during closure.

The surgery is typically completed in about 90 minutes to 2 hours. Your hospital stay may last for one or two days. A thin tube may be inserted in your breasts for a short time to drain the excess fluids and blood collected at the operation site. Your breasts will be covered with a surgical gauze for a while. Women will be asked to wear a surgical bra for several weeks after the surgery to reduce the swelling and provide support to your breasts during the recovery period. Before your discharge from the hospital, the surgeon will provide you with specific instructions for the applications of medicines, taking care of yourself at home, warning symptoms to look out for at the operated area, and follow-up appointments.

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.

References

  1. Calobrace MB. Plastic surgery: Volume 5: Breast. 4th ed. Philadelphia, PA: Elsevier; 2018. Chapter 4, Breast augmentation.
  2. American Board of Cosmetic Surgery [Internet]. Indiana. US; Breast Augmentation Guide
  3. Cleveland Clinic [Internet]. Ohio. US; Breast lift
  4. American Society of Plastic Surgeons [Internet]. Illinois. US; Breast lift
  5. Brown RH, Chang DK, Siy R, Friedman J. Trends in the Surgical Correction of Gynecomastia. Semin Plast Surg. 2015;29(2):122-130. PMID: 26528088.
  6. National Health Service [Internet]. UK; Having an operation (surgery)
  7. Health direct [internet]. Department of Health: Australian government; Breast uplift
  8. Townsend C, Beauchamp RD, et al. Sabiston textbook of surgery: the biological basis of modern surgical practice. 20th ed. Philadelphia, PA: Elsevier; 2017. Chapter 35, Breast reconstruction.
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