Breast Lift

Have your breasts lost their shape or firmness? Do they sag? Would you like to have the problem corrected? Or are you, for some reason, considering breast implants?

If you answered Yes to any of these questions, you should know about breast lifts. As the term implies, this procedure-also known as a mastopexy-is designed to raise and reshape sagging breasts.

Why do breasts often lose their shape and firmness and start to sag? Blame it on the force of gravity ("What goes up must, eventually, come down"), pregnancy, nursing, and aging. As we grow older, the skin loses its elasticity and sagging breasts are one result. Not all women encounter this problem, but it's very common.

Women with small breasts, or with breasts that have lost volume (e.g., after pregnancy and nursing), often combine a breast lift with an implant procedure, for larger, firmer, and perkier breasts.

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Q. What can a breast lift accomplish?

A. It can counteract the sagging and loss of firmness, enhance your appearance, and increase your self-confidence. And it works best if your breasts are small and sagging, not extra-large and heavy.

If pregnancy and nursing have left your breasts with stretched skin and less volume, you may be a good candidate for a mastopexy. But hold off if it's possible you'll have more children, since pregnancy may stretch your breasts again and offset the results of a lift. However, this surgical procedure does not usually interfere with a woman's ability to breast-feed.

Q. What else should I know about a breast lift?

A. The best candidates are healthy, emotionally stable women who understand that a breast lift cannot perform a miracle-just better looking breasts.

It's not always a simple, risk-free operation. That's why, if you plan to have one, you should have it performed by a well-qualified cosmetic surgeon, such as Dr. Kapoor. As with any surgery, there are possible complications, including (but uncommon) infection or bleeding, which can result in wider scars. Yes, a lift will produce permanent and noticeable scars, but your bra or bathing suit will cover them. Also, the procedure can result in unevenly positioned nipples and/or a loss of feeling in your breasts or nipples that can be permanent. If you're a heavy smoker, you should know that it's can cause wound healing problems, and often results in wider scars.

Q. What's the first step to take if I'm considering a breast lift?

A. Schedule a consultation with Dr. Kapoor to discuss why you're considering a lift and whether your expectations are realistic. At that time, your breasts will be examined and measured, and you'll discuss all the variables that can have an impact on the results: your health condition, age, breast size and shape, skin condition, allergies, activities, where the nipples and areolas will be positioned (they'll be higher), etc. You'll also be told about the risks, limitations, scarring, where the operation will take place, and the type of anesthesia to be used. In regard to the cost, be aware that the procedure is usually not covered by insurance.

Dr. Kapoor may ask you to have a mammogram before surgery, and you will be given guidelines in regard to eating, drinking, smoking, medications and vitamins that may affect results. You should arrange to have someone drive you home after the procedure, which is done on an outpatient basis (no hospital stay, in most cases), and perhaps stay with you for a few days if need be.

Q. What happens during the procedure?

A. Usually, a breast lift is performed in an outpatient surgery center. You'll be under general anesthesia and asleep throughout the operation, which takes from two to three hours. However, if only a small incision is needed, you may be given a local anesthesia along with a sedative to induce drowsiness. In that case, you'll be awake, relaxed, and feel only a little discomfort.

Once you're sedated, your surgeon will begin the incisions, outlining where the breast skin is to be temporarily removed and where the nipples will be relocated. When these procedures are completed and the breasts lifted, the skin is brought down and reattached with stitches.

However, if your breasts are small, with minimal sagging, you may be eligible for a modified, less intrusive procedure. Such as the "doughnut" or concentric mastopexy, which involves circular incisions around the areola and the removal of a doughnut-shaped area of skin.

And if you're also having an implant procedure at the same time, each implant is inserted into a pocket directly beneath the chest wall muscle (pectoralis major).

Q. What can I expect after the procedure?

A. For a few days, you'll have to wear an elastic bandage or a surgical bra over gauze dressings. During that time, your breasts will look and feel bruised, swollen, and uncomfortable, with moderate pain that can be relieved with prescription medicine. To relieve very dry breast skin, apply a moisturizer several times a day, but keep it away from the sutures.

A few days after surgery, remove the bandage or surgical bra and switch to a soft support bra, which you'll wear for up to four weeks. After a week or two, depending on how your breasts are healing, the stitches will be removed.

For about six weeks after surgery, there will be some loss of feeling in the nipples and breast skin, due to the swelling. As the swelling goes down, the numbness usually fades, but for some patients there's numbness for as long as a year or more. On rare occasions, it's permanent.

Healing takes time, and is deterred by smoking. You may feel well enough to walk around your home after a day or two, but (if at all possible) don't return to work for at least a week or two. Avoid sex for a week or more. For three or four weeks, avoid strenuous sports and lifting anything (including children) higher than your head. After about a month, if you're feeling okay, you can slowly resume your normal activities. But if you have any unusual or severe symptoms, notify your surgeon. Should you become pregnant, a breast lift does not (in most cases) affect your breast-feeding ability, because it does not damage the milk ducts or nipples.

What about scars? During the procedure, your surgeon will do his utmost to make them as inconspicuous as possible. Initially they will be more visible and they may appear red and lumpy. With time, though, they'll usually become less visible and fade to a large degree.

Chances are, you'll appreciate your breast lift very much. However, due to the same reasons mentioned earlier-aging, gravity, pregnancy, weight fluctuations-your younger-looking breasts won't stay up and firm forever. (If you've also had implants at the same time, the results may last longer.) Meanwhile, enjoy the new you!