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Introduction

Breast lift or Mastopexy is a technique designed to improve the shape and position of the female breasts without reducing their size. It is a term used for breasts which sag but are not necessarily too large. Sagging of the breasts may have many causes and could occur with normal development for some women or as a natural part of aging. Pregnancy, breast-feeding, hormones, diet, doing exercises and weight loss are other conditions which increase breast ptosis (sagging). If your breasts are very empty then some patients will obtain a better shape to their breast by enlarging, if an implant is used at the time of mastopexy - this is called an augmentation mastopexy.

Please understand that mastopexy surgery is safe but cannot be performed without some degree of scarring. The scars, on average, usually heal well but in some cases they can persist for a few years.

"Breast lift or mastopexy with or without implant, is considered by most experts in the field of cosmetic surgery to be one of the most difficult breast operations"
Mr Paul Banwell, FRCS(Plast)

 

It is becoming increasingly obvious to the savvy plastic surgeon given the spectrum of breast shapes, sizes and conditions that simply use silicone breast implants alone will not always produce  the best aesthetically acceptable results. In assessing breast geometry and design, the doctor and plastic surgeon must consider 3 crucial parameters, and their effects:

  • Breast Volume & Shape
  • Skin condition
  • Nipple position

Although augmenting breasts to boost the cups and bust of a woman is a method which can to some extent rectify the volumetric problem in otherwise perfectly shaped breasts, the issues relating to nipple position and excessive skin envelope cannot always be addressed. This is where surgeries like a minimally invasive augmentation maxtopexy is used.

Breast ptosis (pronounced "toe-sis") or droopiness is a condition that affects women of all ages. Although we tend to associate breast ptosis with old age, the statistics say young girls after significant weight loss or post-breast-feeding, are often faced with varying degrees of droopiness. For these women wearing a supportive bra is essential in order to disguise their saggy breasts.

Breast ptosis can be classified by surgeons according to the position of the breasts and nipples in relation to the breast fold:

  • Grade 1: Breast is below fold, Nipple-areola at fold
  • Grade 2: Breast is below fold, Nipple-areola is also below fold
  • Grade 3: Nipple-areola pointing to the floor

Lollipop Vertical Mastopexy scar

 

Lollipop (vertical mastopexy) breast lift surgery is therefore designed to return breast shape to a more youthful appearance in 3 ways:

  • Move the position of nipple-areola complex
  • Remove excess breast skin
  • Reshape the breast tissue

Although alternative mastopexy techniques, like a circumareolar does not change the amount of breast tissue a woman has, it can change the shape dramatically. This in turn can affect the overall breast size and projection. However, there are many cases where breast lifting needs to be combined with a breast implant to produce a desirable bigger breast size. The combined breast lift-augmentation is considered one of the more difficult operations in plastic surgery. It can be performed in either one stage or more commonly in two stages.

Modern plastic surgery is about creating a naturally looking minimal scar in return for achieving the most desirable aesthetic outcome. The prospective patient should be aware of this delicate balance prior to embarking on this procedure.

Breast Lift scarring

The breast lift surgery available is basically performed using 4 types of incisions or scars:

2 Types of Nipple re-positioning procedures with little effect on the breast shape but effective in aligning nipple-areolar complex:

  • Cresenteric scar (half-moon) Lift
  • Donut-shaped scar (periareolar) around the nipple-areola complex (Benelli-Goes)

2 Types of Breast Lift procedures that can re-shape the breast and modify the nipple-areolar position for moderate to severe droopyness (ptosis):

  • Lolly-pop scar from the areola to the breast crease
  • Anchor-shaped scar, inverted T-scar

Further to the skin scarring pattern, breast tissue often needs to be surgically contoured from an elongated shape into a more youthful conical structure.

Frequently Asked Questions

  • What happens to the circulation and sensation of my nipple?

    Generally, the nipple-areolar complex (brown part of the breast) is carried on some breast tissue to keep it alive. This usually preserves the nipple sensation and keeps it viable but sometimes the blood supply is compromised and the nipple may scab (necrosis)

  • How long will you be in hospital?

    An augmentation mastopexy is usually performed as an inpatient procedure requiring hospitalisation. Usually suction drains (plastic tubes) are left in place for a day or two. 

  • What kind of anaesthesia is used?

    A general anaesthetic is used for all augmentation mastopexies.

  • Who is on the surgical team?

    Mr Banwell will always perform the operation.

  • What can I expect postoperatively?

    Discomfort, swelling, slight pain and discolouration of the breasts are to be expected for several weeks. Usually, our patients return to almost normal activity within 10 days. The scars at the incision lines typically become reddish, raised, and firm a few weeks after surgery, but after many months become pale and soft. After 12-24 months, the scars are relatively inconspicuous but in some cases may stay persistently red. The nipples and some areas of the skin may be numb or sensitive after surgery. Sensation frequently returns within a few weeks or months but may be diminished or overly sensitive.

  • Will the breasts start to sag again?

    Gravity continues to have its effect, and there is a tendency for the skin of the breast to stretch over a long period of time. Women vary a great deal in this respect. In general, the smaller the breasts, the less tendency for sagging to recur. If the breasts sag further, minor revisions or reviews may be needed to reverse the process. If Mr Banwell tries to lift heavy breasts without making them smaller at the same time, sagging will return much sooner. One key point to a satisfying result is having realistic expectations.

  • What are my limitations in activity post-operatively?

    You should plan to avoid activities, which require much lifting of the arms above the level of the head for 2 weeks after surgery. With great care, you can drive about 7-10 days after surgery as long as you feel confident to perform an emergency stop. Patients can usually return to work in a few days unless their occupation requires particularly strenuous movements and lifting. In such cases, 2-3 weeks should be allowed. Walking can commence within 7 days,light jogging within 4 weeks,

  • What are the complications involved?

    Surgical risks may include: infection, bleeding, asymmetry, keloid scarring, skin ruckling, difference in nipple size, shape and heights and nerve damage. Damage to the blood supply of the nipple-areolar complex, although uncommon, can occur.

Please contact Mr Banwell's office on 01342 330302 or email help@paulebanwell.com for further information.

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Skin Care

At a Glance

SURGERY TIME
2.5 - 3 hours

HOSPITAL STAY
2 - 3 Nights

ANAESTHETIC ASSESSMENT
No

PRE ADMISSION TESTS
Possibly

SLEEPING POSITION
Sleeping on back recommended for 4 weeks.

REASONABLY MOBILE
1 day

WASHING
Shower after 1 day. Bath after 2 weeks.

DRIVING
3 weeks

EXERCISE INCLUDING GYM
8 weeks

SEXUAL ACTIVITY
Restricted activity after 4 weeks

FULL RECOVERY
8 weeks

TIME OFF WORK
2 weeks

BRAS & GARMENTS
Sports bra worn for 8 weeks. Wired bra after 2 months.

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