Base-line information you need to know about
breasts in order to make the informed choices
if you are considering cosmetic surgery
to your breasts
It is important to
realise several facts:
- Most women have
one breast larger than the other.
- Most women have
one breast that sits lower on the chest
wall than the other.
- Breasts are composed
of a mixture of fat and glandular tissue.
The glandular tissue (the part which secretes
breast milk) weighs more than the fat,
so the larger the proportion of glandular
tissue your breasts have, the heavier
they are and the more they will droop
- Breast fat increases
and decreases in tandem with variations
in body fat generally.
- Breast glandular
tissue increases and decreases in tandem
with variations in female hormones (for
instance before and after menstruation
Armed with these pieces
of information, you will find it much easier
to decide whether this operation is for
you, and which variant of this operation
will suit you best.
Mastopexy is an operation
that raises and reshapes your breasts. If
your breasts are small or have lost volume,
mastopexy can be combined with breast
augmentation to increase their size
Commonly asked questions
about Mastopexy (breast lift)
a good candidate for a mastopexy?
This is best decided
during a consultation, but generally speaking
this operation is beneficial for women in
good physical and mental health, who have
reasonable expectations of surgery that
will raise and reshape sagging breasts.
Large breasts can be lifted, but because
they are subject to the forces of gravity
to a greater degree than smaller breasts,
surgery may be a more suitable option. Likewise,
breasts which have lost substance after
breast-feeding, or weight loss may not be
restored to their former glory, simply by
lifting them during a mastopexy; in order
to truly rejuvenate them, you may benefit
from combining a mastopexy with breast
If you are planning to have children it
is best to postpone your breast lift. Pregnancy
will stretch the skin of your breasts and
breast-feeding will usually decrease the
substance of them. Inevitably therefore,
the cosmetic results of a mastopexy will
be diminished - rather than repeat it later,
you might prefer to wait till your family
I be able to breast feed after having a
After mastopexy there
is a theoretically-increased risk that breast
feeding may not be possible - although,
because it is usually a less radical operation
than a breast reduction, it is less likely
to damage your breast-feeding capability.
That said, whether or not this type of surgery
interferes with breast-feeding is contentious
and several studies of women who’ve
undergone the more radical operation of
breast reduction, suggest their ability
to breast feed after surgery is equivalent
to an age-matched population of women who
have not had surgery.
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affect my nipples?
Nipple sensation may
decrease after surgery, but is less likely
in mastopexy than in the larger operation
of breast reduction.
The blood supply to the nipple and areolar
skin may be compromised and part or all
of one or both nipple-areolar complexes
may die as a very rare complication of mastopexy
and is more likely in people who smoke or
have diseases affecting the small blood
vessels to the skin.
Finally, the colour of nipple-areolar complexes
may lighten or darken after surgery: this
is more likely in dark skinned races or
a mastopexy affect me when I need to participate
in breast screening?
Cancer screening may
be more complicated after a mastopexy in
so far as damage to fat and alteration of
the breasts’ architecture may make
interpreting mammograms harder. Generally,
if women over 35-years-old have a base-line
mammography before surgery and then again
after their mastopexy has settled at say,
6 months after the operation, to give a
Radiologists the potential for comparison
later, there is unlikely to be a problem.
should I expect from my consultation?
During your consultation,
I will take a full medical history. I will
ask you specifically about any breast disease
you have suffered, as well as any previous
surgery you may have undergone and about
your family’s history of breast diseases
such as cancer. If you have had mammograms,
I will need to know the results. I will
also ask about your desired breast size
and shape and anything else related to the
appearance of your breasts that you feel
I will examine you completely, then focus
on your breasts to assess their size, symmetry
and shape and the quality of their skin
envelope. I will then take standardised
photographs in order to help plan and discuss
your operation. Finally I will measure you
for a sports-type bra, which you will choose
and bring with you to be used as a comfortable
dressing over your surgical dressings in
the days immediately after your surgery.
By all means bring pictures from magazines
to show me examples of women who seem to
have breasts of a size that equate with
your desired breast size - these will be
useful in discussion.
the surgery performed?
The technique I use
for your mastopexy will depend on the size,
symmetry and position of your breasts on
your chest wall. I will minimise skin incisions
as far as is compatible with providing you
a predictable, stable and aesthetic breast
shape. There will always be a scar around
the areolar skin and vertically down to
the skin fold under the breast; thereafter
a scar in the skin fold beneath the breast
may be necessary, but will be minimised.
The bulk of the operation involves repositioning
your nipple and areolar skin within repositioned
and sculpted breasts.
On occasion I may use liposuction to remove
fat from the armpit area to improve the
aesthetics of your breast and torso.
When a mastopexy is combined with augmentation,
the implants are placed in surgically created
pockets beneath the newly formed breast
or below the pectoral muscles on the chest
does my operation involve?
Before surgery, you
will meet and be assessed by your anaesthetist
who will prescribe medications for your
comfort and to lessen anxiety if need be.
On the evening before, or the morning of
your operation I will review what we have
discussed and planned previously and we
will both sign your operative consent forms.
Then, with you sitting upright, I will measure
and draw guidance marks for surgery on your
chest and breasts.
The operation is performed under General
Anaesthesia - you will be asleep. The operation
usually takes 1-2 hours, depending on the
technique used. After surgery, you will
awake in a recovery area and soon afterwards
you will be returned to your room. A drain
is placed under the incision in each breast
to remove the normal healing fluid that
the body produces and stop it accumulating
within your reduced breasts. These drains
will be removed when the drainage is minimal
- usually after a day or two and once they
have been removed you can shower normally.
Most patients go home a day or two after
surgery on simple pain relieving medications
and a short course of antibiotics.
about my recovery and return to normal activities?
You will feel tired
and somewhat sore for a week or two following
your surgery, but you will be able to move
around and function relatively normally.
You will have buried, soluble stitching
which will dissolve and doesn’t need
to be taken out.
Generally, you can return to work if your
occupation is sedentary, after 3 - 4 weeks,
but if your work involves heavy lifting
or is strenuous in other ways, for instance
women police officers, 6 - 8 weeks might
be a more realistic period off work. So
long as you can do so with due care and
attention, you can begin driving 3 - 4 weeks
You should restrict yourself to light exercise
for 2 - 3 weeks - avoiding lifting anything
over 5Kg and aerobic exercise for at least
Your breasts will be swollen for at least
6 - 8 weeks, but at that stage your new
breasts will have attained almost their
final appearance. Your final operative result
will continue to mature for 3-6 months and
your scars will continue to mature for up
to a year.
New scars benefit from friction-free massage
(using vaseline, for instance, to lubricate
the massaging process). Beginning to massage
scars two to three weeks after surgery,
will help them mature, soften and flatten
faster than if left to their own devices.
New scars should be protected from sunlight
for 2 years to avoid them pigmenting differently
to the surrounding skin and becoming a different
colour permanently. Factor 15 sun block
should be applied whenever they are exposed
- even to a British winter sun.
In the longer term, final size, shape, symmetry
and aesthetic result of breasts after reduction
surgery will vary according to individual
factors which are due to genes, life style,
life events and gravity. After surgery,
lack of support, alterations in weight or
hormonal variation may alter your breasts’
appearance and symmetry markedly.