At Buckhead Plastic Surgery, Atlanta
Droopy, sagging breasts are a frustrating reality for many women and the reason that breast lift surgery (mastopexy) to restore the breast to a perkier, more youthful position has gained such popularity. By lifting the underlying breast tissue, the breast will sit higher in a more visually pleasing position.
Breast lift surgery or mastopexy literally reshapes the breasts. It can change them from a flat droopy shape to a higher, rounder more aesthetically pleasing youthful shape.
Breast implants can be used at the same time to increase the size of the breast and add more perkiness as well as more cleavage, thus restoring a more youthful look. The results of breast lifting (mastopexy) surgery can last for decades as long as the patient maintains her weight and uses proper supportive bras.
Deciding if Breast Lift Surgery is Right For You
A woman's breasts usually begin to change at around 30 years of age. Causes of breast sagging include:
- Hormonal influences
- Hereditary traits
- Weight loss
As the hormones fluctuate with pregnancy there is a rapid growth in breast tissue with a subsequent loss of breast fat. As pregnancy or breast-feeding come to an end, the breast changes that occurred during pregnancy and lactation revert to their pre-pregnancy state minus the fatty tissue that helped fill the breast. Also, some of the supporting structures of the breast were stretched during this time of breast fullness, leading to sagging.
Women can have an emotional roller coaster when a beautiful event like pregnancy or breast-feeding adversely affects the size and shape of their breasts. Most women visiting Dr. Alan N. Larsen's practice say things like: “I want my breasts to be normal again” or “I want my breasts to be full and perky like they were before.” Since there is a loss of fatty tissue with pregnancy, therefore a loss in volume of the breasts, many women often have a breast lift with a small implant placed at the same time to restore their size shape and perkiness all at once.
The key reason for having a breast lift is to correct changes that have occurred in the breast shape. The nipple and breasts are now sagging in varying degrees. The least severe type of sagging occurs when the upper breast is flattened and the nipple areolar complex is above the lower breast crease. The degrees of ptosis can be more pronounced to where the nipple actually points straight towards the ground. Different degrees of ptosis have different surgical options for their correction.
The best technique for a woman's breast lift must address the shape of the breast, the location of the scars, the quality of the scars, the longevity of the lift, preservation of sensation to the nipple and areola, and preservation of lactation. The degree of sagging or ptosis and the amount of excess skin play a major part in determining the best technique.
How It's Done
During your consultation and physical exam, the specific technique will be reviewed. Lesser degrees of ptosis can be treated by simply removing a small strip of tissue from above the nipple and areolas and sewing the nipple and areolas to the new elevated position. As ptosis progresses, incisions that go around the nipple and areolas (circumareolar) are used. This technique will tighten excessive skin as well as lift the breast and nipple into its new position.
The most ptotic breasts, however, will require an incision that goes around the nipple areolar complex (circumareolar) with an extension of the incision from the nipple areolar complex down the middle of the breast to the inframammary crease and possibly extend along the inframammary crease. This technique affords the largest lift and the most tightening of the breast envelope.
Breast Lift Incision techniques include:
- A concentric or donut-shaped incision around the areolas.
- A concentric or donut-shaped incision around the areolas with the addition of the vertical component down from the areolas to the breast crease (the technique Dr. Larsen uses most often).
- Inverted T: a concentric or donut-shaped incision around the areolas plus the vertical component from the areolas to the breast crease as well as a horizontally based incision along the breast crease.
A breast lift does not change the amount of breast tissue a woman has. It does change the shape and position of the nipple areolar complex. An optical illusion occurs when the breast is changed from a long, flattened breast to a perkier rounded breast. Lifted breasts will look smaller than the ptotic breast, however, they are the same size and will fill out a bra the same way.
Results to Expect
A breast lift or mastopexy alone cannot make the size of the breasts larger and usually makes them look smaller however they will not change in size. Lifting the breast creates an optical illusion: changing a long, droopy, flattened breast which looks large to a perkier rounded breast actually makes it look smaller.
A breast lift does not mean you can go without wearing a bra. Not wearing a bra will more quickly lead to a sagging breast. A breast lift may or may not prevent changes from further pregnancies. You should wait until you are finished having children before lifting your breasts.
Different surgical techniques for the breast lift or mastopexy will result in different postoperative expectations. The final outcome, however, is the same: perkier, more youthful breasts. The smaller incisions will heal faster with less swelling and less discomfort. The results will also be visualized very quickly.
The larger procedure with the incisions around the areolas and down the middle of the breasts will take a little longer to heal (see the final result) will often have a more bruising and there will be more swelling and discomfort. With any surgery the scars initially will look very nice. The scars will then turn pink followed by fading that can take a year or more to complete.
Immediately after surgery, you will experience mild to moderate discomfort which is easily controlled with pain medication. You will be sent home after surgery. Follow-up will start the next morning when the dressings will be removed. Follow-up will continue every few days for the first week or so after which your visits will be staggered longer apart as your healing progresses.
Most women return to work in 3-5 days and regular activities after two weeks if everything is healing well. The first few weeks after surgery, you will wear a loose fitting bra. As healing continues and the discomfort resolves, you can then wear a regular supportive bra.
In Dr. Larsen's practice, drains are not placed for this surgery. After surgery you'll have padding placed across the breasts. The padding will be held gently in position with an ace bandage. You will be seen in follow-up the next day when the ace dressing will be removed and you will be placed into a loose fitting sports bra or a shelf bra inside a camisole.
You should sleep sitting upright for the first 4-7 days after surgery to help with swelling and discomfort. About two weeks after surgery, you will be placed into a more supportive bra and can return to a full exercise routine. Most women return to work 3-5 days after surgery.
The results should last for decades. Different factors such as weight gain and loss, a new pregnancy and/or breast feeding and your general tissue characteristics will influence the longevity. Not wearing a supportive bra will also lead to early secondary drooping.
Schedule Your Consultation
Are you interested in finding out if breast lift surgery is right for you? Contact the office of double board certified plastic surgeon Dr. Alan N. Larsen. Our plastic surgery office is located in the Buckhead area of North Atlanta. Call (404) 367‐9005 to schedule your consultation.