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Breast Lift / Breast Reduction (below) Breast Lift If you’re considering a breast lift…… Over the years, factors such as pregnancy, nursing, and the force of gravity take their toll on a woman’s breast. As the skin loses its elasticity, the breasts often lose their shape and begin to sag. 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.) Mastopexy 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. If you’re considering a breast lift, this brochure will give you a basic understanding of the procedure-when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask your doctor if there is anything about the procedure you don’t understand.
The best candidates for breast lift A breast lift can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon. The best candidates for mastopexy are healthy, emotionally stable women who are realistic about what the surgery can accomplish. The best results are usually achieved in women with small, sagging breasts. Because of any size can be lifted, but the results may not last as long in heavy breasts. Many women seek mastopexy because pregnancy and nursing have left them with stretched skin and less volume in their breasts. However, if you’re planning to have more children, it may be a good idea to postpone your breast lift. While there are no special risks that affect future pregnancies (for example, mastopexy usually doesn’t unterfere with breast-feeding), pregnancy is likely to stretch your breasts again and offset the results of the procedure. 1-Over time, a women’s breasts begin to sag and the areolas become larger.
All surgery carries some uncertainty and risk A breast lift is not a simple operation, but it’s normally safe when performed by a qualified plastic 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. Planning your surgery In your initial consultation, it’s important to discuss your expectations frankly with your surgeon, and to listen to his or her opinion. Every patient-and every physician, as well-has a different view of what is a desirable size and shape for breasts. The surgeon will examine your breasts and measure them while you’re sitting or standing. He or she will discuss the variables that may affect the procedure-such as your age, the size and shape of your breasts, and the condition of your skin-and whether an implant is advisable. (For more information on implants, ask your surgeon for the ASPRS brochures on breast augmentation) You should also discuss where the nipple and areola will be positioned; they’ll be moved higher during the procedure, and should be approximately even with the creases beneath your breast. Your surgeon should describe the procedure in detail, explaining its risks and limitations and making sure you understand the scarring that will result. He or she should also explain the anesthesia to be used, the type of facility where the surgery will be performed, and the costs involved. Don’t hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results. Preparing for your surgery Depending on your age and family history, your surgeon may require you to have a mammogram (breast x-ray) before surgery. You’ll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. While you’re making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed. 2-Incisions outline the area of skin to be removed and the new position for the nipple. 3-Skin formerly located above the nipple is brought down and together to reshape the breast. Sutures close the incisions, giving the breast its new contour. 4-After surgery, the breasts are higher and firmer, with sutures usually located around the areola, below it, and in the crease under the breast. Where your surgery will be performed Your breast lift may be performed in a hospital, an outpatient surgery center, or a surgeon’s office-based facility. It’s usually done on an outpatient basis, for cost containment and convenience. If you’re admitted to the hospital as an inpatient, you can expect to stay one or two days. Types of anesthesia Breast lifts are usually performed under general anesthesia, which means you’ll sleep through the operation. In selected patients-particularly when a smaller incision is being made-the surgeon may use local anesthesia, combined with a sedative to make you drowsy. You’ll be awake but relaxed, and will feel minimal discomfort. The surgery Mastopexy usually takes one and a half to three and a half hours. Techniques vary, but the most common procedure involves an anchor-shaped incision following the natural contour of the breast. 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 liftt, it will be placed in a pocket directly under the breast tissue, or deeper, under the muscle of the chest wall. After your surgery 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. The stitches will be removed after a
week or two. 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 hear for three to four weeks. If you have any unusual symptoms, don’t hesitate to call your surgeon. Your surgeon will give you detailed instructions for resuming your normal activities. 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 inconspicuos 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. Breast Reduction If your considering breast reduction… Women with very large, pendulous breasts may experience a variety of medical problems caused by the excessive weight-from back and neck pain and skin irritation to skeletal deformities and breathing problems. Bra straps may leave indentations in their shoulders. And unusually large breasts can make a woman-or a teenage girl-feel extremely self-conscious. Breast reduction, technically known as reduction mammaplasty, is designed for such women. The procedure removes fat, glandular tissue, and skin from the breasts, making them smaller, lighter, and firmer. It can also reduce the size of the areola, the darker skin surrounding the nipple. The goal is to give the woman smaller, better-shaped breasts in proportion with the rest of her body. If you’re considering breast reduction, this brochure will give you a basic understanding of the procedure-when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask your doctor if there is anything about the procedure you don’t understand.
The best candidates for breast reduction Breast reduction is usually performed for physical relief rather than simply cosmetic improvement. Most women who have the surgery are troubled by very large, sagging breasts that restrict their activities and cause them physical discomfort. In most cases, breast reduction isn’t performed until a woman’s breasts are fully developed; however, it can be done earlier if large breasts are causing serious physical discomfort. The best candidates are those who are mature enough to fully understand the procedure and have realistic expectations about the results. Breast reduction is not recommended for women who intend to breast-feed.
All surgery carries some uncertainty and risk Breast reduction is not a simple operation, but it's normally safe when performed by a qualified plastic surgeon, Nevertheless, as with any surgery, there is always a possibility of complications, including bleeding, infection, or reaction to the anesthesia. Some patients develop small sores around their nipples after surgery; these can be treated with anitbiotic creams. You can reduce your risks by closely followoing your physician's advice both before and after surgery. The proceduce 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 proceduce can also leave you with slightly mismatched breasts or unevenly positioned nipples. Future breast-feeding may not be possible, since the surgery removes many of the milk ducts leading to the nipples. Some patients may experience a permanent loss of feeling in their nipples or breasts. Rarely, the nipple and areola may lose their blood supply and the tissue will die, (The nipple and areola can usually be rebuilt, however, using skin grafts from elsewhere on the body.)Planning your surgery In your initial consultation, it’s important to discuss your expectations frankly with your surgeon, and to listen to his or her opinion. Every patient-and every physician, as well-has a different view of what is a desirable size and shape for breasts. 1- Heavy breasts can lead to physical discomfort, a variety of medical problems, shoulder indentations due to tight bra straps, and extreme self-consciousness. The surgeon will examine and measure your breasts, and will probably photograph them for reference during surgery and afterwards. (The photographs may also be used in the processing of your insurance coverage.) He or she will discuss the variables that may affect the procedure-such as your age, the size and shape of your breasts, and the condition of your skin. You should also discuss where the nipple and areola will be positioned; they’ll be moved higher during the procedure, and should be approximately even with the crease beneath your breasts. Your surgeon should describe the procedure in detail, explaining its risks and limitations and making sure you understand the scarring that will result. The surgeon should also explain the anesthesia he or she will use, the facility where the surgery will be performed, and the costs. (Some insurance companies will pay for breast reduction if it’s medically necessary; however, they may require that a certain amount of breast tissue be removed. Check your policy, and have your surgeon write a “predetermination letter” if required.) Preparing for your surgery Your surgeon may require you to have a mammogram (breast x-ray) before surgery. You’ll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Some surgeons suggest that their patients diet before the operation. Breast reduction doesn’t usually require a blood transfusion. However, if a large amount of breast tissue will be removed, your physician may advise you to have a unit of blood drawn ahead of time. That way, if a transfusion should be needed, your own blood can be used. While you’re making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.
The surgery Techniques for breast reduction vary, but the most common procedure involves an anchor-shaped incision that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. The surgeon removes excess glandular tissue, fat, and skin, and moves the nipple and areola into their new position. He or she then brings the skin from both sides of the breast down and around the areola, shaping the new contour of the breast. Liposuction may be used to remove excess fat from the armpit area. Type of anesthesia Breast reduction is nearly always performed under general anesthesia. You’ll be asleep through the entire operation.
Where
your surgery will be performed Breast reduction is generally done in a hospital, as an inpatient procedure. The surgery itself usually takes two to four hours, but may take longer in some cases, you can expect to remain in the hospital two to three days.
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Surgery is
performed in a first class state-of-the-art outpatient surgical center or hospital
staffed by physician anesthesiologists. Your safety and comfort are our priority.
