What is mastopexy?
A mastopexy, is an operation which raises and reshapes sagging breasts to give a more youthful position.
What does the surgery involve?
Incisions are made to sculpt the breasts into a new shape, reduce the excess skin and raise the nipple/areola area (the dark skin surrounding and including the nipple) to a higher position. The incisions may include one or more of the following:-
- Around the areola
- Vertically down from the areola to the breast crease
- Horizontally in the breast crease
A breast lift operation does not change the amount of breast tissue a women has but it does change the overall shape and position. Breast implants can be inserted at the same time as breast lift surgery to increase breast size or to improve fullness.
The surgery takes about two hours to complete.
This procedure is normally performed under a general anaesthetic (you will be unconscious during the procedure).
The operated area may be swollen for a few days and you will experience some pain. Simple painkillers are all that is normally required although aspirin should be avoided for the first few weeks following your operation.
Providing all is well, you can expect to go home the day after surgery.
What are the risks and side effects of surgery?
Having cosmetic surgery can be a very positive experience. Complications are infrequent and usually minor. However, no surgery is without risk and it is important that you are given a clear picture.
Rarely a haematoma (collection of blood in the wound) can occur. This is most likely to occur within 24 hours of surgery. Large haematomas may need to be drained in the operating theatre, under a general anaesthetic.
Infection may occur but again this is rare. Infections can usually be treated successfully with antibiotics.
Everybody heals differently, and this is not always predictable. Poor or delayed healing occasionally occur. These healing difficulties can range from minor problems, such as small areas of wound separation, to major issues, such as skin or nipple loss. Although very rare, this situation may require a skin graft to close the wound, meaning more surgery. People who have diabetes, smoke, are obese or elderly are at an increased risk of delayed healing.
There is always permanent scarring where the incisions were made. Although these usually fade and soften up to a year after surgery, scars can occasionally thicken and stretch. Darker skinned people have more of a chance of forming thick scars (hypertrophic or keloid scars). The scars are designed so they lie under the average bra or bikini top.
Since breast lift surgery usually repositions the nipples, there is a risk that you will suffer changes in nipple sensation and the nipples’ ability to become erect.
Future breast feeding may not be possible following this operation so if this is important to you, you may need to discuss this with your surgeon and possibly postpone surgery until your family is complete. It should be remembered that a lot of ladies who have not had any surgery are unsuccessful at breast feeding.
Breast asymmetry/shape irregularities can occur and in rare cases, further surgery is needed to correct this.
Fat necrosis. Occasionally, areas of fat and breast tissue within the breast form sore lumps. This problem occurs because the blood supply to the breast tissue is reduced during the operation. Usually, no specific treatment is required and the problem settles down over about 12 months.
General risks linked with any operation can occur. Formation of a blood clot in the leg (known as a deep vein thrombosis) can occur which would require treatment although the risk of this happening is very rare. Part of these clots can also break off and move up to the lungs. This is known as a pulmonary embolus or P.E. (very rare but can be life threatening). Developing a chest infection is rare but more likely to happen to people who smoke.
All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, do not hesitate to discuss these with your surgeon. Decisions about cosmetic surgery should never be rushed.
How do I prepare for surgery?
Following your consultation, if you decide to proceed with an operation, a range of dates will be offered to you. You may be invited to attend the hospital for a pre-operative assessment with a nurse. Depending on your age and general health, routine blood tests and a heart tracing (ECG) may be taken. You will be given the opportunity to ask any questions you may have or raise any concerns.
You will be admitted to the hospital on the day of your operation. If you are having a general anaesthetic, you will be asked not to eat anything six hours before surgery. Black tea/coffee or non-fizzy drinks (nothing containing milk) can be taken up to two hours before surgery. Chewing gum should also be avoided six hours before your operation.
It is important to inform your surgeon, anaesthetist and nurse of any medicines (self or GP prescribed) or recreational drugs you take. Medicines containing aspirin should be avoided for two weeks before the operation since they increase the risk of bleeding during surgery. If there are any other medications that may affect surgery then this will be discussed with you at your first appointment.
If you smoke, you should consider giving up several weeks before your operation. The longer you give up beforehand, the better. Smoking reduces the amount of oxygen in the blood and can significantly increase the risk of healing problems after your operation. If you can’t stop completely, cutting down will help.
You will not be able to drive yourself home from hospital and ideally, you should have someone to stay with you for a few days to lend a hand.
What happens after the operation?
Once you have recovered from your anaesthetic, you will be encouraged to sit up in bed.
A small tube (called a drain) may be placed in each breast to drain off blood and fluid. These tubes are usually removed the next day before you go home.
You should wear a sports bra day and night for the next three weeks to give support and help to mould the breast tissue to its new shape. After this time, a bra should be worn during the day as normal. Avoid wearing an underwired bra for at least the first four weeks.
Before you leave the hospital, you will be given a follow up appointment to see either the surgeon and/or nurse. This is to check on your progress and also the wounds. If non-dissolvable stitches are used, these will usually be removed at a week to 10 days after surgery.
What is the estimated time for recovery, absence from work and return to usual activities?
Recovery times vary from one person to another so use the times given as a guide only. If you have any concerns during this period, do contact the hospital team for advice.
In the first two days after your operation, it is important for you to be out of bed and walking every two hours during the day and early evening. Staying in bed too long increases your chances of developing clots in the legs. Gradually increase your activity over the next few days.
Avoid sunbathing topless for up to a year after the operation and certainly for the first few months. The scars are more sensitive to sunlight and burn more easily. Make sure that you apply a high factor sun screen.
Mastopexy post surgery timeline
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Day 1 to 7
You may have some discomfort for a week. Mild painkillers will help with this but avoid taking aspirin.
Keep walking around to avoid post operative complications.
Sports bra worn day and night for about 3 weeks
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Week 2
Might pull and hurt a little when you move around.
Any non dissolvable stitches would be removed
Gradually begin to increase your activity
Depending on your job, should be able to return to work from 2 weeks
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4 to 6 weeks
Avoid lifting or pushing anything heavy for at least 4 weeks
No need to wear a bra during the night but keep one on during the day
Loss of sensation to breast and nipple area continues to improve
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6 to 9 months
Scars will begin to soften and fade.
Can start to judge the result.