Breast form remains, perhaps, the most visual symbol of femininity and female sexuality in society today. The form and shape of the breast may change with as affected by several factors over the years. The pubescent firmness and position of the breast gland may be compromised by the natural aging process, the effects of gravity, breast feeding, pregnancy and hormonal fluctuations. To return the breast to a more youthful shape and position a breast lift operation may be contemplated. In this procedure the breast tissue is literally physically lifted higher onto the chest wall, where it is secured. Excess skin is then removed, retaining the new shape and position of the breast. Several techniques are available for your plastic surgeon to choose from and are dependent on the amount of breast sagging (ptosis) to be corrected. More recent trends in breast lift surgery call for smaller and shorter scars.
The classic incisions (scars) for breast lift and breast reduction surgery involve an inverted T or anchor incision, which goes around the areola, vertically down to and then along the natural fold beneath the breast. This results in a long scar and is generally reserved for extreme cases of breast sagging (ptosis).
The vertical scar mastopexy includes a periareolar incision, which then extends vertically down to the breast fold only. This may also be termed the “lollipop” scar or incision. This incision technique may render the breast more susceptible to nipple sensation changes and breast feeding limitations.
The third choice in breast lift incision is the periareolar incision. This incision is limited to encircling the areolar only. It is usually reserved for cases of minimal breast ptosis and may also carry the potential to affect nipple sensation and breast feeding.
The procedure is performed on an outpatient basis, in either a hospital, ambulatory surgical facility, or doctor’s office operating suite. Anesthesia is typically an intravenous sedation along with local anesthetic injection or alternatively, a general anesthesia (completely asleep). The operation may take anywhere from two to four hours on average depending on the technique used. Drains may or may not be placed depending on your plastic surgeon’s practices. Many plastic surgeons require the use of a support bra for up to 2 months after surgery to help maintain the new breast form and position during the healing process.
Whichever technique/incision is chosen, the breasts will be lifted and tightened on the chest wall creating a more youthful and aesthetically pleasing appearance.
Many women are plagued by a condition known as macromastia (large breasts), also commonly called breast enlargement or hypertrophy of the breasts. This condition may lead to real physical symptoms such as neck pain, back pain, breast pain, rashes beneath the breast folds and bra strap indentations into the shoulders. These symptoms usually identify a breast size that is out of proportion to the body habitus, but may simply identify large heavy breasts causing symptoms even in larger women. The medical and plastic surgery solution to this sometimes disabling condition is breast reduction surgery (reduction mammaplasty). The procedure has enabled countless thousands of women to become more productive in their daily lives and in society and to generally feel better about their self image.
Breast reduction surgery may take any where from 2 to 4 or 5 hours depending on the amount of tissue to be removed and the technique chosen for the procedure. Sometimes drains (small plastic tubes) are left in place to allow fluids to escape from beneath the newly shaped breast. Usually the surgery requires a general anesthesia, again depending on the amount of tissue to be removed and the technique used. There is about a 2-3 hour recovery room stay, resulting in an 8 hour day, after which the patient is discharged home.
The classic incision (scar) pattern for breast reduction surgery is the inverted T or the anchor shaped incision. This scar encircles the areolar complex, travels vertically down the lower breast and extends horizontally along the lower fold of the breast from the sternum (breast bone) to the axilla (armpit). The modern trend in techniques for breast reduction surgery is toward procedures which limit the amount of external scarring. These techniques involve incisions that may be called periareolar (around the areolar complex only), or vertical (around the areolar complex and vertically down the middle of the lower breast in a lollipop design). Not every patient is a candidate for these limited incision techniques depending on many factors, such as, skin quality and amount of tissue to be removed. Consultation with your Board Certified plastic surgeon would determine the appropriate incision for your situation.
Many surgeons will place a post surgical bra after your surgery, others will place a circular compression type bandage (i.e. ACE wrap), which may be used for several weeks after, while the breast is healing in its new form, size and position. Generally, one full week off from work is required. Exercise may be resumed anywhere from 2 to 6 weeks after surgery depending on many factors and to be determined by your plastic surgeon. Follow up office visits usually occur a few days after surgery, 1 to 2 weeks after surgery, 6 weeks after surgery and then every 3 to 6 months for one year or so.
As with any surgery there are risks and complications which can occur. A full consultation with your plastic surgeon should allow you the opportunity to learn about these risks before undergoing any surgical procedure.
