Mastopexy (Breast Lift)Mastopexy (breast lift) is a very frequent procedure in Dr. Capella's practice. He has personally performed over 700 breast lifts. This represents one of the largest experiences in the Metropolitan area.
Background On Mastopexy
Either because of changes following pregnancy, with the passage of time or following weight loss, breasts can begin to sag and look aged. This represents the effects of gravity and tissue stretching and leads to a disproportion between the amount of skin (excess) and the amount of breast gland (deficiency). In severe forms the nipple points downward, rather than forward. The procedure, known as mastopexy (breast lift), is performed to rearrange the skin in such a way as to give the breasts a more youthful, firm appearance. Mastopexy can also decrease the size of the pigmented area around the nipple known as the areola. If the volume of breast tissue has decreased, as often occurs after breastfeeding and/or weight loss, then a breast implant can be placed at the time of the mastopexy to make the breasts appear larger and firmer.
A thorough medical history and directed physical examination are obtained at the time of your consultation. Dr. Capella will examine your breasts, making measurements of the amount of sag and sizing the proportions of your existing breast tissue with respect to your rib cage size. Any existing scars are evaluated to give the doctor an idea of your scarring potential.
He will tell you at the time of your visit exactly the approach he would recommend to provide you with the best possible result, while minimizing scarring. Other details, such as whether a breast implant would be of benefit in your particular situation, are discussed.
Mastopexy Pre-Operative Visit
It is imperative that patients refrain from ingesting any medications or other substances that could potentially be the cause of surgical complications. A list of medications should be reviewed and discontinued at least two weeks prior to operation. Patients are seen just prior to their surgery date for a general physical examination to ensure that no underlying medical problems exist that may interfere with the safety of their surgery. Specifically, any infections that arise prior to operation, however seemingly trivial, should be reported to our office. Even an otherwise innocent infection can result in a surgical wound infection, and must be treated prior to surgery. Women, age 30 and above, must obtain a baseline mammogram prior to surgery.
Prophylactic antibiotics are given at the time of surgery and for 24 hours following surgery to reduce the risk of surgical wound infection. A prescription for pain medication is also written, so that you have pain pills when you return home from the operation.
Pre-operative photographs are taken so that you can see the improvement from your surgery afterwards. We generally take post-operative photographs at 3-6 months after your procedure. You will be asked to sign a surgical consent, which enumerates the risks of the procedure in detail. These risks have been explained here, but are also discussed at the consultation.
You will need to arrange for an escort to drive you to and from the operating suite. Patients cannot operate motor vehicles after surgery and recently sedated patients will not be placed into taxis for transport home. We can arrange for medical transportation in the event that you cannot find an escort. It is mandatory to have someone stay with you for at least 24 hours after surgery for your comfort and safety.
Day Of Mastopexy Surgery
Breast lifts are typically performed with general anesthesia. Mastopexy usually takes two hours. There are several techniques that Dr. Capella utilizes. When the amount of breast sag is small, only an incision around the areola may be necessary. With more sag, a vertical incision extending down from the areola may be necessary. For more severe forms of sagging breasts, a horizontal incision at the base of the breast may be necessary. If a breast implant is placed, that is done through these same incisions, and is usually placed below the breast and below the chest muscles.
Mastopexy Recovery Process
At the conclusion of the procedure, sterile dressings and a surgical bra will be placed over your breasts. The breasts become bruised, swollen, and tender for a week or so, but the pain should not be severe, and is usually well controlled with the pain medication that is prescribed. After two days, the sterile dressings and bra may be removed for showering. Mild soap may be used. Scrubbing of the breasts should be avoided. Following the shower, the surgical bra may be replaced or any soft or supportive bra that does not have an underwire. Some patients feel more comfortable wearing a supportive bra day and night for the first week following surgery and during the day for the next several weeks. Though the skin of the breast may feel numb for a while, usually the feeling returns in 6-8 weeks. It normally takes approximately 6-8 weeks for all of the initial swelling to subside, and it takes one to two years for the scars to mature and fade.
Risks Of Mastopexy Surgery
Complications of breast surgery are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection, bleeding, or a reaction to the anesthetic or sedative medications. You may have temporary or even permanent areas of altered sensation, including numbness. There is usually some difference in the size of breasts normally, and this is almost never perfectly correctable. There can be fairly lengthy skin incisions that require a period of up to a year or two for completion of the scarring process for optimal appearance. In some ethnic skin types, scarring can be more prominent, and may require further treatment. The doctor will discuss your particular scarring potential in more detail at the time of your consultation. When breast augmentation is performed in combination with the mastopexy procedure, you need to be aware of the additional risks this imposes.