Mastopexy (Breast Uplift Surgery) by Jan Stanek at Surgical Aesthetics

This operation lifts up breasts which have sagged, without making them bigger or smaller.  Droopy breasts can be restored to give a more youthful shape.  Mastopexy is also used to improve breasts which have an unusual shape, such as those where the crease is high so that the nipple and areola descend over it and point downwards.  By lifting the nipples to a better position and changing the position of the crease underneath, a mastopexy can produce a more normal appearance.

The most common reason for doing this operation is when a woman has had children, or lost weight and the breasts have become droopy with the nipples lying lower than the breast crease when she is in upright position.  If the nipple is above the crease, then breast augmentation is a better choice.  Often the skin of the breast seems stretched after having children, and the breast contents may have shrunk so that the skin no longer fits nicely over the breast tissue.  The aim of the operation is to reduce the amount of skin, lift the nipple and then re-drape the skin so that it gives the breast a better shape.

If the breasts are droopy because they are very bulky, then a breast reduction should be performed.  This combines the skin tightening and nipple raising operation with removal of breast tissue.  If, on the other hand, the breasts are going to be too small even when raised to a better position, then mastopexy can be combined with augmentation.

There are no exercises which can shrink stretched skin.  Once a breast has drooped exercises will not help.  A good supporting bra worn routinely, particularly during pregnancy, is the best prevention.

Before the operation, the new nipple site is marked with the patient standing.  Under general anaesthetic, an incision is made around the edge of the areola, and skin on the lower part of the breast is removed, but not the breast tissue.  The nipple is lifted to its new position, often a few inches higher, and the skin is brought together underneath.  There are several techniques available, depending on the surgeon’s preference, and on the case in question.  There will be scarring which is permanent.  Usually this is around the areola, and then in a vertical line down to a scar in the crease which may be variable in length.  After the wound is sutured, a padded dressing is applied, and the patient usually goes home the following day.  

As with any type of surgery, this operation may be subject to complications: 

  1. Scarring: Although the surgeon will try to make the wound look as neat as possible, it is unlikely that the scar will ever completely disappear. Occasionally the scars may stretch or become red and raised and may require further treatment.

  2. Infection and post-operative bleeding: This can occur in any operation and is normally treated with antibiotics. Bleeding may require further surgery or aspiration of a clot, should this lead to a swelling.

  3. Soreness and pain: This is likely to be present soon after the operation but is not usually severe.

  4. Recurrence: In some patients there is a risk that the problem may recur and the breasts may become droopy again afterwards. The chance of this happening is reduced by wearing a well-fitting support bra

  5. Sensitivity of the nipples: This may well be reduced or altered. Except for a small minority, this will return to normal.

  6. Asymmetry: All breasts are asymmetrical. Every attempt is made by the surgeon to achieve a better symmetry but complete symmetry is impossible.

  7. Loss of a nipple: Although rare, blood supply to the nipple can be compromised after surgery, leading to partial or complete loss of the nipple. It is more common in smokers, especially if they continue to smoke after surgery.

It is essential that any patients contemplating mastopexy should first discuss in detail the pros and cons of the operation with their surgeon.  It is only then that the patient can decide whether or not to proceed with surgery.

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