Breast Lift Surgery
With normal aging, most women experience some degree of drooping or sagging with their breasts. The degree of sagging will vary according to number of pregnancies, substantial weight fluctuations, hereditary factors and hormonal changes that naturally occur. Unfortunately, sagging will not improve over time and cannot be corrected with exercise or special bras.
When sagging is troublesome enough for the patient, breast lift surgery is the only way to improve the appearance. Breast lift surgery removes excess or stretched skin and raises the breast position on the chest. The nipple position is also usually elevated and the size of the areola is typically reduced.
Breast size increases with pregnancy and this causes the skin to stretch. Most women then lose breast volume after the pregnancy. The combination of stretching of the skin and losing volume tends to give the breast a deflated appearance. Most of the time it is best to look into breast lifting options when a mom is finished having children.
The goals of the breast lift surgery are:
- remove excess skin
- reposition the breast tissue to a higher position on the chest
- elevate and improve the position of the nipple
- reduce the size of the areola
Most patients that are truly fed up with breast sagging feel the scars that come with the surgery are well worth it. The scars are well covered by almost all types of clothing and swim suits. Likewise, women who want to improve the position and size of the areola do not mind having a scar around the perimeter of the new nipple location.
A small amount of sagging
If sagging is minimal, but there is not enough breast volume, simply placing an implant for breast augmentation may be the best option.
If a younger patient is not willing to accept the additional scars that come with breast lift surgery, she may choose to have augmentation with an implant. She can always return at a later date for the lift.
Saggy and too small
This the most common finding for breast lift patients. They definitely would benefit from the lift, and there is not enough remaining breast tissue to fill out the upper portion of the breasts. In these patients, doing a lift by itself will leave the upper portion of the breast hollow or “scooped out.” A small implant placed at the time of the lift can correct this lack of volume.
Saggy with adequate breast volume
This situation is not as common and is easily addressed with the breast lift alone. This allows for removal of the excess skin and returning the breast tissue to a higher position on the chest. In addition, the nipple position is improved and the diameter of the areola can be adjusted.
Saggy and too large
This is another common situation and is easily addressed by removing some of the heavy breast tissue from the lower or outer portion of the breast at the time of the lifting. By repositioning the breast and reducing some of the weight of the breast, many patients report reduced pain in their upper back, neck, and shoulders.
A breast lift and a breast reduction are essentially the same surgery. The main difference is the amount of tissue removed. With a breast reduction typically 500 to over 2000 grams (or 1 to 4 pounds) of tissue is removed per breast. This type of surgery is more complex than placing implants alone. As such, there is a greater variation in the predictability of the results as well as patient expectations.
Although the size and position of the nipple/areola is altered, the nipple is not removed and replaced. The nipple remains attached to the underlying breast tissue. The scars are present around the new location of the nipple, a vertical line going done toward the base of the breast and usually a short horizontal line in the crease at the base of the breast. There are no scars in the upper portion of the breast.
The procedure is performed by James M. Shaw, MD, a board certified plastic surgeon, under general anesthesia in an outpatient surgery center. A board certified anesthesiologist will be immediately available at all times. After the anesthetic wears off, you will go home the same day. You will need a responsible adult present to drive you home.
It is recommended that you stay home and minimize arm activities for the first four or five days after breast surgery. Use cold packs or ice as much as possible. After four or five days, most patients are ready to return to work or school or begin running errands. Strenuous exercise and heavy lifting should be avoided until about three weeks following surgery.
It is normal to have some bruising and swelling following surgery. Also the lowest part of the breast should be tight and even a little over-corrected. This area will relax and settle over the first few months.
A sports bra may be used instead of the surgical bra, if desired. Wear the type of support that you find to be most comfortable.