Over the years, factors such as pregnancy, nursing, and the force of gravity take their toll on a woman’s breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. A breast lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts–at least, for a time. (No surgery can permanently delay the effects of gravity.) A breast lift can also reduce the size of the areola, the darker skin surrounding the nipple. If your breasts are small or have lost volume–for example, after pregnancy–breast implants inserted in conjunction with mastopexy can increase both their firmness and their size.
Breast Lift Considerations
A breast lift is not a simple operation, but it’s normally safe when performed by a qualified cosmetic surgeon. Nevertheless, as with any surgery, there is always a possibility of complications or a reaction to the anesthesia. Bleeding and infection following a breast lift are uncommon, but they can cause scars to widen. You can reduce your risks by closely following your physician’s advice both before and after surgery.
Mastopexy does leave noticeable, permanent scars, although they’ll be covered by your bra or bathing suit. (Poor healing and wider scars are more common in smokers.) The procedure can also leave you with unevenly positioned nipples, or a permanent loss of feeling in your nipples or breasts.
Breast Lift Surgery
A breast lift usually takes one to two hours when performed by the Drs. Carlotti as a surgical team. When this procedure is performed by only one surgeon in other practices, it is not uncommon for it to take up to 3-4 hours. Thus the advantage of the Carlotti Center to minimize operative time as well as the benefit of four trained hands and their combined experience as a surgical team.
For the technique used by Drs. Carlotti, the incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola are moved to the higher position. The skin surrounding the areola is then brought down and together to reshape the breast. Stitches are usually located around the areola, in a vertical line extending downwards from the nipple area, and along the lower crease of the breast.
Some patients, especially those with relatively small breasts and minimal sagging, may be candidates for modified procedures requiring less extensive incisions. One such procedure is the “doughnut (or concentric) mastopexy,” in which circular incisions are made around the areola, and a doughnut-shaped area of skin is removed.
If you’re having an implant inserted along with your breast lift, it will be placed in a pocket directly under the breast tissue, or deeper, under the muscle of the chest wall.
Again, this procedure is always peformed by two surgeons at the Carlotti Center for Cosmetic Surgery. This expedites the procedure and affords you four trained hands, two sets of trained eyes evaluating symmetry and patient safety during the procedure. During your consultation with either Dr. Albert Carlotti or Dr. Michelle Cabret-Carlotti, they will discuss the best surgical option for you as well as implant selection (if necessary) as well as describe in detail which incision design is best for you to achieve your desired result.
After Your Breast Lift Surgery
After your breast lift, you’ll wear an elastic bandage or a surgical bra over gauze dressings. Your breasts will be bruised, swollen, and uncomfortable for a day or two, but the pain shouldn’t be severe. Any discomfort you do feel can be relieved with prescribed pain medications. Within a few days, the bandages or surgical bra will be replaced by a soft support bra. You’ll need to wear this bra around the clock for three to four weeks, over a layer of gauze. Most incisions are closed with dissolvable sutures and do not need to be removed. The stitches around the circumference of the areola (nipple) will be removed painlessly between 7-10 days in most cases.
You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This numbness usually fades as the swelling subsides over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.
Getting Back to Normal
Healing is a gradual process. Although you may be up and about in a day or two, don’t plan on returning to work for a week or more, depending on how you feel. And avoid lifting anything over your head for three to four weeks. If you have any unusual symptoms, don’t hesitate to call your surgeon.
Drs. Carlotti will give you detailed instructions for resuming your normal activities after your breast lift. You may be instructed to avoid sex for a week or more, and to avoid strenuous sports for about a month. After that, you can resume these activities slowly. If you become pregnant, the operation should not affect your ability to breast-feed, since your milk ducts and nipples will be left intact.
Your New Look
Your surgeon will make every effort to make your scars as inconspicuous as possible. Still, it’s important to remember that mastopexy scars are extensive and permanent. They often remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be placed so that you can wear even low-cut tops.
You should also keep in mind that a breast lift won’t keep you firm forever–the effects of gravity, pregnancy, aging, and weight fluctuations will eventually take their toll again. Women who have implants along with their breast lift may find the results last longer. Your satisfaction with a breast lift is likely to be greater if you understand the procedure thoroughly and if your expectations are realistic.