What to expect at Initial Consultation
At your initial consultation I will spend time to get to know you personally, understand your lifestyle and take a full medical history. As a woman and a Plastic Surgeon, I intimately understand how your feelings about your breasts can influence body confidence, self-image and femininity. I aim to give you the result you are looking for and to do this I really need to understand your likes, dislikes and expectations. It is important that you are open and honest at this stage so that I can appreciate your reasons for seeking a breast lift and your expectations for the outcome. I will then examine your breasts, and if you are an appropriate candidate for this surgery, your options will be described in detail. Where I feel an alternative surgery will better achieve what you have described this will also be fully explained. Whatever we decide you will be given full details of the type of surgery, its risks and limitations. I always see you for a second consultation prior to booking surgery to ensure that you have had time to fully digest the options and information I have given you.
Preparing for Mastopexy
You should be physically fit and at your ideal weight which should be stable prior to embarking on Mastopexy. Your health will be assessed pre-operatively and you may need some tests that will be arranged if required. You should stop smoking at least 6 weeks ahead of surgery to reduce the risk of wound healing problems. You should stop aspirin, anti-inflammatory medications and any non-prescribed medication at least a week before surgery. If there is any change in your health prior to your surgery date you should let me know. Your health and general well being are my primary concern when I am treating you therefore if you are unwell for any reason it may be necessary to postpone surgery.
What To Expect on the day of Surgery?
Mastopexy is perfomed under a general anaesthetic as a day case procedure. It usually takes 2-3 hours depending on the patient. An incision is made as per your individualised treatment plan, excess skin is removed, the nipple is lifted and the breast tissue rearranged. The wounds are closed with dissolvable stitches and I do not usually use drains. You will be back on the ward around an hour after the procedure and able to go home later that same day.
In some patients liposuction is added to a mastopexy to help shape the outer of the breast, providing a better contour, and reducing the “axillary roll” (armpit fat) and back roll regions which may otherwise compromise the aesthetic result. We will have decided together pre-operatively whether this is something that you need to achieve your desired outcome so it won’t come as a surprise. When you have liposuction you may be bruised in the area for several weeks post-op.
What to Expect After Surgery
You should arrange for someone to pick you up following surgery and have someone to stay with you overnight. For the first few days you will need some support at home. In the initial post-operative period you will feel swollen and will have some discomfort requiring analgesia. You will be asked to wear a supportive post-op bra immediately and for six weeks day and night. You should keep the wounds dry until your first dressing change at one week.. You should avoid any strenuous exercise in the first week and should continue to wear a support bra for 6 weeks after surgery. You will be able to start light exercises after a week and normal exercise by 2-3 weeks provided you have a supportive bra. You should begin massage to the scar once healed, a simple moisturiser can be used for massage. Bruising and swelling last for a few weeks and redness and discharge may occur. The two breasts often settle down at different rates so you may notice some asymmetry in the initial weeks. It can take many months to years for the scars to fade.
What are the Potential Complications of Mastopexy Surgery?
Early in the post-operative phase you may notice bruising, swelling, altered nipple sensation and a difference between the two sides. All of these are common and most settle down over the first few weeks. Nipple sensation may be either increased or decreased and these changes may persist for a few months or even a year but are rarely permanent. Any operation under general anaesthetic carries risks of DVT, PE and cardiac or respiratory complications. Complications that are occasionally seen following surgery are haematoma, seroma, infection and delayed healing. Loss of the nipple areola complex has been described but is rare.
In some patients the scars may be red and obvious for some time before fading. In those susceptible to poor scarring thickened sensitive scars may persist for some time following surgery and in some cases require treatment. With time breast tissue continues to age and the recurrence of droopiness will depend upon changes to the body through pregnancy and weight change and the quality of your skin and soft tissues.
Will I be Able to Breast Feed?
All breast procedures should ideally preserve the functions of the breast; breast-feeding and pleasure (sensation). The aim of the mastopexy is to reshape the breast rather than to remove tissue so the underlying structures should remain intact. Therefore the ability to breast-feed should be retained however, some women may be unable to breast-feed even without having breast surgery.
Will I Need Additional Surgery after a Mastopexy?
Unless you have an augmentation-mastopexy there should be no need for future surgery. However, it is important to remember that mastopexy resets the clock, it does not stop time. Your breasts will continue to age, just like the rest of you however they will be starting from a perky new shape and would normally stay natural-looking and youthful for many years. If you subsequently have variations in weight or if you have very poor quality skin the longevity of the results will be affected. Unlike implants there is no reason to undergo any additional surgery unless you are experiencing a problem or unless you wish to do so.
Implications For Mammograms And Screening
If you are of screening age you should be up to date with screen prior to embarking on surgery. The surgery should not interfere with future mammograms. You need to tell the mammography service that you have had breast surgery although it will not change your management.
Is a Mastopexy Part of a Mummy Makeover?
This very much depends on how pregnancy and breast-feeding has affected your body! Mastopexy is a frequent component of a Mummy Makeover, with or without implants. Please see my Mummy makeover section to learn more about common body changes after pregnancy and how a Mummy Makeover addresses these.