Sagging of the breast may be due to the weight of the breast alone, or be exaggerated by multiple pregnancies and loss of skin elasticity with time, as found with our clients from Gold Coast & Brisbane. As the skin stretches the breasts sag and lose shape. Mastopexy is designed to correct that sag and restore a better shape to the breast.
Often there is sufficient breast tissue present and all that one needs is tightening of the skin envelope, also known as breast lift or breast augmentation. However, shrinkage of the breast tissue may occur after pregnancy or with weight loss and breast augmentation may also be required. It will all depend upon how much tissue you have there and what your expectations are.
Dr Scamp will discuss the situation in your particular case at consultation. Mastopexy reduces the size of the breast skin envelope, raises the nipple to its original position, reshapes the breast and reduces the size of the areola (the darker skin surrounding the nipple). In many ways, mastopexy is very similar to breast reduction with of course the difference being that no breast tissue is removed. Surgery is often possible using smaller scars than used in breast reduction.
Breast prostheses can be inserted at the same time if an actual increase in breast volume is required. If your breasts are of reasonable size but have sagged too much, then mastopexy may be the procedure for you. If you think your breasts have sagged but are a little too large, then a small reduction may be required with the mastopexy. If you feel your breasts are too small and too saggy, then breast augmentation combined with repositioning may be required. In some people simply augmenting the breast alone by inserting a prosthesis is sufficient to mask the sag by “filling” the breast out more.
This has the advantage of using a minimal scar. Ask Dr Scamp if he feels you are suitable for this procedure. It is best to do a mastopexy procedure after you have had all your children and your breasts have settled from pregnancy. Further pregnancy may stretch out the scars and undo the improvement to the shape that one gets from mastopexy. It is however, often possible to breast feed after mastopexy should you fall pregnant again, and the procedure can be repeated if necessary.
What are the risks?
All surgery carries with it some risk. Bleeding and infection are common risks in all surgery. Avoid medications that are prone to make you bleed prior to surgery. These include aspirin, high dose vitamin E and arthritis pills. Red wine and smoking also increase your risk of bleeding.
You will be given antibiotics at the time of the surgery to reduce your risk of infection.
Most patients lose sensation to their nipples after breast lift. Ninety percent of people get return of sensation by approximately three months. Some people even say their sensation is better than it was prior to surgery. There is a risk however, that you may permanently lose sensation to both nipples, or that the sensation may take a year or more to return. This is particularly true when breasts are very sagged. It is common to have a difference in the shape and the size of your two breasts.
At surgery, every attempt will be made to closely match the size and position of your breasts. However, there is commonly some residual difference. Rarely, especially when the repositioning is particularly large or the patient is diabetic or smokes, circulation to the nipple may be lost and the nipple may die and leave a scar. It is possible to reconstruct the nipple using grafts from elsewhere in the body.
By avoiding smoking for six weeks prior to surgery and getting yourself close to your ideal weight prior to surgery, you can substantially reduce the risk of this rare event occurring. Occasionally, the scars of breast repositioning require revision 12 or more months after surgery. It is important to be as close as possible to your ideal weight prior to surgery. Weight loss after a breast repositioning may result in the breasts looking wide, flat and empty, and they may sag again.
The surgery is also safer if weight is reduced prior to surgery. The risk of complications is reduced as the tissues are less tense when manipulated at surgery. It is also much easier to judge the ideal size for your build when your weight is close to the ideal range. If your surgery is done when you are overweight and you subsequently lose weight, you will find that you may need further surgery to reshape the breasts. Strange as it may sound, occasionally women even request breast augmentation (enlargement) when they have undergone breast reduction followed by substantial weight loss.
Getting yourself in the best possible shape prior to surgery will reduce the risk of this occurring and make the procedure safer for you. As mentioned above, mastopexy often involves smaller scars than breast reduction. This is important as the procedure is more often performed for cosmetic reasons than breast reduction is. Doctor Scamp will choose the technique, which is most likely to get you the best result with minimum scarring.
Planning your surgery
If you contact Dr Scamp’s office (ph: 07 5539 1000), his staff will be able to give you an idea of costs for the surgery including hospital or day theatre costs and anaesthesia costs. His staff will also send you some information to read on the surgery, and answer some of your questions.
At consultation, Dr Scamp will examine you and listen to your wishes. He will advise you as to whether a reduction, augmentation or a straight mastopexy procedure is most likely to achieve those wishes.
Preparation for surgery
If you are over 40-years-old it is usually advisable to have a mammogram performed prior to surgery. Your general practitioner can arrange this for you. You should plan to cease smoking for at least six weeks prior to surgery as this interferes with the safety of the procedure. You should also avoid medication which makes you bleed such as vitamin E, aspirin and arthritis pills.
Red wine and smoking also increase your risk of bleeding. Make sure that you arrange for someone to take care of you in the first few days after surgery if you are having your mastopexy procedure done as a day patient.
Where will the surgery be performed
Mastopexy may be performed as a day patient or in hospital. Some people prefer to stay one or two days in hospital especially if they have young children at home.
Mastopexy is done under general anaesthesia. Once you are asleep, local anaesthetic injections are also given into the breast itself to make you as comfortable as possible when you wake up. These injections last 8-12 hours and substantially reduce the discomfort of the procedure.
Mastopexy takes approximately two hours depending upon the size of the breast. The most common scar from mastopexy is in an anchor shape. There is a circular scar around the nipple/areola, a vertical scar extending down to the fold beneath the breast and a scar along that fold. In some patients, short scar techniques (Lejour, Benelli) are possible, especially where the sag is not severe and the patient is young and close to their ideal weight.
The nipple is not detached from the breast, but simply rotated up by excising some skin above it and freeing up the tissue around it. The wounds are then closed using internal stitches. A drain is commonly placed to each breast. Through these incisions, it is usually possible to place a prosthesis below the muscle behind the breast, if such is required.
Most people can return to work a week after surgery. Two weeks break should certainly see you fit. Physical activity is discouraged until two weeks after surgery. Gentle return to exercise at that stage is advised. The breasts are likely to remain tender to touch for several weeks thereafter.
Getting back to normal
You will need a week off work. Many clients from Gold Coast, Brisbane & other places have felt that two weeks is required for recovery. Avoid physical activity for those two weeks but thereafter you should be able to return gradually to your exercise program. It is probably not advisable to buy a new bra until at least six weeks after surgery.
Your shape and size will settle as the swelling disappears. Removing the excess skin of a sagged breast may lead to minor size loss from the breast so bra size can occasionally change. The scars themselves take about a year to get to their best but are usually quite presentable after three months. Remember, however, that the scars are permanent and in some people they can be raised or red (keloid). The scars are designed and placed to be inconspicuous even in low-cut clothing.
By using sutures that absorb slowly and tapes to support your scar, Dr Scamp aims to provide you with the best possible scars from your surgery. With mastopexy, the breasts often sit a little high on the chest wall after surgery, and take a few months to reach their final shape and position.
While it will take you time to get used to your new shape, and it will take time for the breast themselves to get to look their best, you will probably find that the improved comfort is there immediately. Write down any questions that you have and bring them with you at the time of your consultation, or telephone and ask our friendly staff.