MASTOPEXY
Breasts are fundamental parts of a woman’s beauty, femininity, and sensuality. From puberty to best age, they change size, shape, position, and become flaccid. This happens because the breast support tissues and fibers lose resistance and strength due to the natural effect of gravity (over the years), pregnancy (and breastfeeding), hormone changes (birth control pills and menopause), weight variations, and even smoking. The breasts fall (ptosis) and become flaccid.
It is not possible to end breast flaccidity, but it is possible to lessen its effects. In addition to healthy living and eating habits, some alternatives delay sagging, such as the use of skin firming creams, and a good quality modeling bra. Practicing exercises to strengthen the pectoral muscles also helps, as well as aesthetic procedures (such as radiofrequency) stimulate the contraction of the collagen and ligaments present in the breast.
WHAT IT IS AND HOW IT IS DONE
In some phase of a woman’s life, to a lesser or greater degree, the breasts become pendulous, flaccid, with the nipples pointing downwards and, in some cases, even asymmetrical. If this bothers you, it is very important to perform a careful pre-operative evaluation in order to indicate the Mastopexy – commonly referred to as Breast Lift surgery -, the plastic surgery that can restore the shape, volume and correct the drooping (ptosis) of the female breast.
During the surgery, we also have the opportunity to correct eventual asymmetries between the breasts and/or areolas. It is worth pointing out that the procedure does not significantly change the size of the breasts, nor does it fill the upper part of the breast (lap), but it repositions them and gives them back their youthful aspect.
The procedure lasts an average of 2 to 3 hours, according to the size of the breasts. It can be performed with epidural plus sedation or general or spinal. There are advantages and disadvantages in each one. Together with the anesthesiologist, we choose the safest and most comfortable for the patient.
Mastopexy can be performed through several incision techniques. We choose the appropriate technique based on the size and shape of the breast, whether the ptosis is more or less pronounced, the size and position of the areolas, the degree of sagging of the breast, the quality and elasticity of the skin, and the amount of excess skin.
If the ptosis is more advanced and the breast has a lot of tissue, we can use the technique called “Anchor or Inverted T” with three incisions: one around the areola, another vertical from the areola to the base of the breast and a third horizontal in the crease between the breast and the thorax. Associated with this technique, it is possible to perform a breast reduction surgery Reduction Mammaplasty.
If the ptosis is moderate, we use the “Lollipop Lift” technique, whose incisions are made around the areolas and from them to the base of the breast. The “Periareolar or Circular Lift”, indicated for those who have a small fall of the breasts, the removal of flaccid skin is done through an incision made around the areolas. If the patient wants more voluminous breasts, these techniques can allow the inclusion of breast prostheses associating the surgery to the Augmentation Mammaplasty.
After the incisions, we lift and reshape the underlying breast tissue in order to improve the firmness and contour of the breast. We reposition the nipples and areolas to the apex of the breast cone. If necessary, we reduce the areola that has become enlarged over time (or is disproportionately enlarged) by excising the surrounding skin.
After reshaping, we remove the excess skin and close the incisions. We make the sutures deep within the breast tissue to support the newly shaped breasts. Some incision lines are hidden in the natural contours of the breast, however, others are visible. Scars are permanent, but most of the time can improve significantly over time.
After the procedure, we may use sutures, skin adhesives, and/or surgical tape in dressings over the incisions. We bandage and/or place a surgical bra to minimize swelling and support the breast. A drain may be temporarily placed under the skin to drain any excess blood and fluid that may accumulate after surgery.
INDICATION
Mastopexy is the plastic surgery indicated for women who are bothered by having fallen breasts, that is, the nipples are positioned below the breast crease, the skin is flaccid and areolas are enlarged or one of the breasts is lower than the other.
The possibility of better results happens when the woman is physically healthy, keeps her weight stable, does not smoke, and, most of all, has realistic expectations.
Although the fall of the breasts in women can occur from adolescence to old age, the age group that most undergoes Breast Lift is between 30 and 50.
The breasts usually fall, especially after great weight loss and after the blessing of having been a mother one or more times. The ideal, in this case, is to wait at least 6 months after breastfeeding and with the weight stabilized to perform the Mastopexy.
Is there any problem if I become pregnant after the procedure? No, there isn’t. Even better if it is at least 3 years later. In the great majority of the cases, the surgery does not impede the woman from breastfeeding and does not take away the sensibility.
PREOPERATIVE
It is very important that you consult the SCHEDULED THE SURGERY? page which has a series of questions to talk about during the consultations, to help you with your doubts and where you will find recommendations for the day of the procedure.
If you have, it is important to talk about family history of breast cancer and bring the latest results of previous mammograms or biopsies.
Besides this, in the case of the Mastopexy, there follows a checklist to help you get organized:
🅐 Spend a good moisturizing cream on the preoperative days (not the day before and not the day of surgery!) on the breast region to help the skin stretch and decrease the chances of stretch marks appearing.
🅑 Prior lymphatic drainage sessions help prepare the body for surgery and reduce the risk of post-surgical complications such as infection, excessive edema, hematomas, and scar tissue.
🅒 Buy a surgical bra from a specialized company and take it with you on the day of the surgery, because it is placed immediately after the procedure. Choose a very comfortable model, fair, but not tight, considering the breast enlargement.
🅓 Make sure that during this most critical period of recovery, from 2 to 3 weeks, nobody depends on you in the family or at work. Following the planning to the letter has the objective of guaranteeing the desired results.
POSTOPERATIVE
The length of hospital stay after the Mastopexy varies from case to case and can be 12 hours (discharge the same day) or 24 hours (an overnight stay). The pain is not usually very bothersome, but you will probably feel it for a few weeks while the swelling begins to recede. The first two days must be of absolute rest, essential for healing and for the elimination of liquids (seroma) through the drain.
Normally, we change the first dressing and teach the others to be done by the patient at home. The use of a post-surgical bra helps to protect, hold, and mold the breasts. It must be worn for a period of 3 months, taking it off only for bathing and dressing. Sleep with your stomach up, with your arms along your body and torso elevated to be more comfortable for at least 1 month.
Opt for lighter food on the 1st day (fruit, soup, gelatin, fiber, liquids etc.). From the 2nd day of the procedure on, we suggest a balanced diet rich in fruits, vegetables and white meats. Avoid sweets, fried food, soft drinks and alcoholic beverages. Hydrate yourself a lot. Use the minimum of salt so as not to increase swelling.
In the first baths after surgery, if you feel dizzy, choose to use a chair. Avoid wetting the dressings, but if this happens, try to dry them carefully with a towel and/or a warm hairdryer at least 20 cm away.
Between the 3rd and 7th day it is already possible to return moderately to daily activities, but without physical effort. Light walks from the 8th day on are allowed; more intense physical activities, after evaluation. Avoid heavy lifting, do not raise your arms above your shoulders or open them too much for at least 15 days, the same time without driving. Avoid as much as possible exposure of the scars to the sun for at least 6 months.
As in the preoperative, schedule lymphatic drainage sessions from 4 to 6 weeks in the postoperative period. Besides eliminating the accumulation of liquid from the body, this treatment activates the immune system, helps to reduce pain and discomfort, relieves bruising and swelling, and is effective in the prevention and treatment of fibrosis and scar adhesions.
During the first 3 months after the Mastopexy, the cone shape of the breasts gives way to a more natural shape, being rounder at the bottom. This process is known as “basculation”. From 6 months to 1 year, we can reach the planned result of the surgery in a calm way with a fine and clear scarring, besides the return of the sensibility in the region before this period.
Over time, your breasts may continue to change due to aging and gravity. The results last longer if you lead a healthy lifestyle, without exaggeration, eating properly, exercising, and maintaining the ideal weight for your biotype.