MASTOPEXY (BREAST LIFT) & AUGMENTATION-MASTOPEXY
A mastopexy (breast lift) is a surgical procedure which corrects breast ptosis (breast droopiness).
The breast skin can be thought of as an ‘envelope’ around the breast tissue; when a breast becomes droopy, the skin envelope stretches and becomes loose, allowing the breast tissue to drop.
It also pulls the nipple down so that it rests on the lower part of the breast. With a mastopexy, these changes are reversed.
It tightens the skin envelope around the breast tissue to make the breast tighter and more ‘lifted’. It also re-positions the nipple higher on the breast in its natural position.
GRADES OF BREAST PTOSIS
There are 3 grades of severity of breast ptosis (droopiness), based on the position of the nipple in relation to the rest of the breast, as well as the point where the breast meets the chest wall (inframammary fold):
Grade I: Mild ptosis; the nipple is below the centre of the breast but and at the level of the inframammary fold.
Grade II: Intermediate ptosis; the nipple is below the centre of the breast and below the inframammary fold.
Grade III: Severe ptosis; the nipple is below the centre of the breast and the inframammary fold and the nipple is pointing to the floor.
For each of these grades, there is a slightly different way of performing the mastopexy to get the optimum results. A mastopexy can also be combined with a breast augmentation (augmentation-mastopexy).
There are 3 common techniques for mastopexy, depending on the severity of the ptosis:
Circumareolar (Benelli) technique
In this procedure a ring of excess skin is removed around the nipple and the breast skin is then pulled towards the nipple, thus tightening the envelope. This leaves a circular scar around the nipple. It is a good technique for those who have mild breast ptosis.
Veritical Scar Technique
In this procedure an incision is made around the nipple as well as a vertical incision below the nipple to remove the excess skin and give the lift. This is a much more powerful technique than the first one and gives a much better breast shape and projection. It is probably the most appropriate technique in most people who have breast ptosis.
In this procedure an incision is made around the nipple, followed by a vertical scar below the nipple, then an incision below the breast in the inframammary fold. This is best used in someone who has lots of excess breast skin, typically someone who has lost a lot of weight.
Most people have this procedure performed under a general anesthetic, especially if combined with breast augmentation. The first 2 techniques can sometimes be performed under a local anesthetic in certain cases. Your surgeon will discuss your options with you and together you can determine which technique is best for you. The surgery is usually a day surgery procedure. You will be given painkillers to use at home after the surgery.
AFTER THE SURGERY
In the days following surgery you may gradually resume normal activities, but avoid overdoing anything. You will be given a post-operative instruction sheet before you go home. Ask your surgeon which activities are safe and which to avoid. Avoid any medications or health products that can increase the risk of bleeding after surgery. Follow-up appointments will be arranged by the surgeon’s office to make sure everything is healing well. Avoid activities that can potentially tear the sutures for about 3-4 weeks.
POSSIBLE RISK & COMPLICATIONS
Although great care is taken to minimize bleeding during surgery, blood may still accumulate around the implant. This occurs in about 1% of cases and usually develops in the first 24 hours after surgery. It is usually one-sided, but can rarely occur on both sides. The affected breast is swollen, painful and bruised. This usually necessitates surgical drainage of the blood and controlling the bleeding.
The risk of infection is about 1%. The affected breast will be hot, painful and red. You may also have fever. It can usually be treated with a course of antibiotics.
The nipples may become more or less sensitive after surgery. This is usually temporary and will return to normal after a few months. It is rare to have permanent change in sensation.