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Breast lift

Definition

A breast lift, or mastopexy, is cosmetic breast surgery to lift the breasts. The surgery may also involve changing the position of the areola and nipple.

Alternative Names

Mastopexy; Breast lift with reduction; Breast lift with augmentation

Description

Cosmetic breast surgery can be done at an outpatient surgery clinic or in a hospital.

You will probably receive general anesthesia before this procedure. This will make you unconscious and unable to feel pain. Or, you may receive medicine to help you relax and local anesthesia to numb the area around the breasts to block pain. You will be awake but unable to feel pain.

Your surgeon will make 1 to 3 surgical cuts in your breast. Your surgeon will remove extra skin and may move your nipple and areola.

Sometimes, women have breast augmentation (enlargement) when they have a breast lift.

Why the Procedure Is Performed

Cosmetic breast surgery is surgery you choose to have. You do not need it for medical reasons.

Women usually have breast lifts to lift sagging, loose breasts. Pregnancy, breastfeeding, and normal aging all may cause a woman to have stretched skin and decreased breast volume.

You should probably wait to have a breast lift if you are:

• Planning to lose weight
• Pregnant or still nursing a child
• Planning to have more children

Talk with a plastic surgeon if you are considering cosmetic breast surgery. Discuss how you expect to look and feel better. Keep in mind that the desired result is improvement, not perfection.

Risks

Risks for any surgery are:

• Bleeding
• Infection

Risks for any anesthesia are:

• Breathing problems, such as pneumonia
• Heart problems
• Reactions to medicines

Risks for breast surgery are:

• Inability to nurse a baby after surgery
• Large scars that take a long time to heal
• Loss of sensation around the nipples
• One breast that is larger than the other (asymmetry of the breasts)
• Uneven position of the nipples

The emotional risks of surgery may include feeling that your breasts don't look perfect, or you may be disappointed with people's reactions to your "new" breasts.

Before the Procedure

If you smoke, you must stop. Women who smoke after breast surgery have a higher risk for delayed wound (incision) healing, infection, and scarring. You must even avoid breathing in secondhand smoke.

Always tell your doctor or nurse:

• If you are or could be pregnant
• What drugs you are taking, even drugs, supplements, or herbs you bought without a prescription

During the days before your surgery:

• You may need to have mammograms or breast x-rays before surgery. Your plastic surgeon will do a routine breast exam.
• Several days before surgery, you may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
• Ask your doctor which drugs you should still take on the day of surgery.
• You may need to fill prescriptions for pain medicines before surgery.
• Arrange for someone to drive you home after surgery and help you around your house for 1 or 2 days.

On the day of your surgery:

• You will usually be asked not to drink or eat anything after midnight the night before surgery.
• Take the drugs your doctor told you to take with a small sip of water.
• Wear or bring loose clothing that buttons or zips in front.
• Your doctor or nurse will tell you when to arrive at the clinic or hospital.

After the Procedure

After you have a breast lift, a bulky gauze dressing (bandage) will be wrapped around your breasts and chest, or you might wear a surgical bra. Drainage tubes may be attached to your breasts. These will be removed within 3 days.

Schedule a follow-up visit with your doctor. Your doctor will want to check your healing, remove sutures (stitches), and discuss special exercises or massaging techniques with you.

Outlook (Prognosis)

You are likely to have a very good outcome from breast surgery. You may feel better about your appearance and yourself. You may need to wear a special supportive bra for a few months to reshape your breasts.

Scars are permanent and often remain very visible for a year after surgery. After a year they fade some. Your surgeon will try to place the cuts so that scars are hidden from view. Your scars will generally not be noticeable, even in low-cut clothing. Surgical cuts are usually made on the underside of the breast.

Normal aging, pregnancy, and changes in your weight may all cause your breasts to sag again.

References

Burns JL, Blackwell SJ. Plastic surgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 73.