One of the more common breast procedures, a breast lift or mastopexy, is surgery that corrects the appearance of saggy, deflated breasts. There are many reasons that breasts can hang lower than you would like and these include genetics, pregnancy, breast feeding, weight loss or gain, and aging. We refer to breast hang as ptosis and it is graded I-III depending upon the position of your nipple to the fold under your breast known as the inframammary crease. Nipples that point toward the ground are considered to be grade III ptosis. Sometimes your nipple can be in good position but all of your breast tissue has descended to the bottom of the breast, leaving the entire upper portion flat. This is known as pseudoptosis and is also addressed by the same procedure. Typically, women will find that after childbirth they experience significant enlargement of the breasts followed by deflation once breast feeding has ended. The reason for this is that the glandular elements of the breast are no longer being stimulated by the excess hormones present during pregnancy and breast-feeding. The result is a flatter, more empty-appearing breast that hangs lower than it did before.
Another problem that can be corrected with mastopexy surgery is asymmetry between the breasts, either in terms of size discrepancy or breast position. Almost every woman has some degree of difference between the right and left breasts, most can be greatly improved with breast lift surgery. Enlarged areolas are also addressed at the same time resulting in a comprehensive correction of all the components of a sagging breast.
A breast lift, or mastopexy, removes excess loose skin and repositions the nipple while tightening the entire breast. This results in a more youthful shape and nipple position giving you a very natural appearing, firm contour. It can be combined with breast augmentation if you so desire, either at the same time or in a second stage procedure. Many women find that after their own breast tissue is moved back into the correct location and the skin envelope tightened they are happy with the size and don’t even need implants.
There are many variations of mastopexy surgery with some having more scarring than others. It is a very individualized procedure that is determined by the particular severity of breast hang. In any case, scars on the breast heal very well and the result is usually a thin white line mostly concealed in the inframammary fold.
The Consult
At the time of your consultation, the degree of breast hang is determined so as to select the proper type of mastopexy for you. As mentioned above, many women are interested in increasing or decreasing the size of their breasts at the same time while others want to stay the same size. The various options will be thoroughly discussed and you will have a chance to look at photos of prior patients whose breasts may have a similar appearance to your own.
Breast lift surgery is a purely elective surgical procedure which means that it is only performed if you are in good health. A full history and focused physical examination is performed at the time of your consultation with the doctor, and clearance from your regular physician is required prior to proceeding with surgery. Safety is our primary concern in aesthetic surgery and we take every precaution to ensure an excellent outcome.
At the completion of your consultation you will have a thorough understanding of what can be done to provide you with a beautiful breast profile. We will determine the procedure tailored to your individual needs so that you make the most well-informed decision possible.
Where are the scars located on the breast after a mastopexy?
There are many different variations of breast lift surgery available depending on the degree of breast hang and laxity. All of the procedures result in a scar around the areola but it is hardly noticeable due to the interface between the different skin colors. In some cases that is the only scar but for more extensive lifts there will be a vertical and horizontal scar as well. Again, a beautiful new shape is always more important than the scars which fade away until they are minimally visible.
Is the procedure painful?
There is minimal pain post-operatively because only skin and breast tissue is involved. All of the sutures are dissolving and the tape over the incisions falls off after about one week. A mildly compressive bra is worn for several weeks afterward, which provides support and comfort while the breast heals. Most women are able to control the mild discomfort with Tylenol or Advil but you are given a prescription for pain killers in the event that you require more relief.
How long will my results last?
Your results will be long-lasting and your nipple should remain in good position essentially for the rest of your life. You may find that there is further atrophy of breast tissue as you age resulting in smaller breasts. If that happens, you may consider breast implants to return some of the fullness that you may have lost. If you do need further tightening many years later it is easily done through the same incisions from your first procedure, but most women won’t need this.
Do you have a lot of experience with breast lift surgery?
I have performed hundreds of breast lifts and all breast procedures are a large part of my practice. I had the opportunity to operate with many surgeons during my training and in doing so developed my own style which incorporates the best of all approaches. In addition to breast lifts I perform breast reduction, breast augmentation, nipple-areolar reduction, and inverted nipple correction, as well as many other breast-related procedures.
How soon can I return to exercise?
I prefer that my patients stay active and in fact require that you are up and walking around the evening of surgery. Light exercise can begin after several days, not including chest-specific weight training though. All restrictions are removed after six weeks, and sometimes even earlier depending on your personal progress. It is important to follow all instructions during the early postoperative period to ensure excellent results. I always remind my patients that they went through the effort to have the surgery and to give themselves the proper time to recover.
What happens on the day of my surgery?
You arrive at the facility approximately an hour prior to your scheduled time of surgery. The skilled nursing staff greets you and takes you to a private room in the preoperative area where you change and complete the admission process. You then meet your anesthesiologist who reviews your history with you and explains the procedure of going to sleep and waking up in the most comfortable and safe way possible. I arrive shortly thereafter to mark you for your surgery and answer any last minute questions that you might have. You receive a single dose of intravenous antibiotics as prophylaxis against infection and are then taken into the operating room where you comfortably drift off to sleep and wake up two hours later with your newly contoured breasts. After a short time in the recovery room you are taken back to the private room where you began before surgery. Your nurse then reviews the postoperative instructions that we provided you with and gets you ready for discharge usually within two hours of leaving the operating room. You can expect a call from me that evening to make sure that you are doing well. Remember, my phone number is provided to you and is on 24/7 for my patients.
Do I see you after my surgery?
You are seen in the office the day after your surgery so that Sarah can answer any questions you may have about the early postoperative period. I see you multiple times out to at least one year following your surgery, and anytime after that if you desire. My goal is to provide excellent and long-lasting results in a practice that is always there for you.
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Right breast mastopexy, left subglandular breast augmentation 150cc MPP silicone implant
Dr. Sterling’s ongoing commitment to patient safety and satisfaction is evident in the personal attention and care he provides to each and every one of his patients.
Dr. Sterling treats patients from all over New England including the northernmost parts of Maine, Vermont and New Hampshire, as well as Massachusetts, Rhode Island and Connecticut. He provides the entire spectrum of cosmetic surgery and is double board certified with both the American Board of Surgery and the American Board of Plastic Surgery.
