What is breast lift (Mastopexy) surgery?
It is an operation that provides an upright position and better form to the deformed and sagging/ptotic breasts by removing little or no volume. In medical language, this breast lift operation is called “Mastopexy”
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Why does the breast droop/sag?
With gravity and aging, the weakening of the ligamentous structures that hold the breast, excessive weight gain and loss, weakening of the supporting structures after pregnancy and breastfeeding, creates a saggy and empty breast structure. The loss of elasticity in the skin and the downward displacement of the nipple position are important in the formation of this appearance. The appearance of the breast, which occurs with loss of elasticity, atrophy of the breast tissue and change in the position of the nipple, can only be corrected by a breast lift surgery performed with personalized planning.
Is breast lift surgery alone sufficient in breast aesthetics? Is it necessary to enlarge or reduce the breast volume?
The current volume of the breast is very important in this decision. In the classical breast lift surgery, the breast volume does not change apparently, but since it is taken higher and some skin and breast tissue can be removed, the lifted breasts appear a little smaller than normal. If the size of the breast tissue is sufficient, the mastopexy procedure alone is sufficient. Breast augmentation can also be achieved by placing silicone implants in breast lift surgery for breasts that have lost volume after pregnancy and breastfeeding, for women who need upper part fullness, and for patients who want a more voluminous breast structure (See Breast Augmentation Section). In medical language, this combination of surgery is called “Augmentation Mastopexy”. In addition to silicone implant placement, fat injections to the upper part of the breast and to the décolleté area will increase the volume of this area (See Fat Injection (Lipofilling) Applications Section). If the breast tissue is large as well as being saggy, the breast tissue can be reduced by switching from classical breast lift methods to breast reduction methods (See Breast Reduction Section).
What should be considered before breast lift surgery?
Breast volume, shape/width/position of the nipple, skin elasticity and skin quality are very important in making a mastopexy plan. Besides, family or personal history of breast cancer, previous breast diseases, other comorbidities, pregnancies, breastfeeding, and future plans to have a new child are evaluated. A routine imaging procedure is performed before the operation (Ultrasound / Mammography). The position of the nipple with respect to the inframammary fold (the fold under the breast) line is evaluated and the degree of breast sagging/ptosis is determined (Regnault classification).
How is breast lift surgery performed?
This surgery is performed under general anesthesia and takes approximately 2-2.5 hours. The breast tissue is raised to a higher position on the thorax (chest wall) with appropriate methods, the upper and medial parts of the breast are filled. The enlarged and deformed nipple areola complex is moved to where it should be and is reduced in size. Excess sagging tissues are removed. In cases where there is an empty breast structure and if an increase in breast volume is planned, silicone implants are placed in the appropriate plan or fat injection is made. If volume reduction is planned, breast reduction techniques are added to the surgery.
What is the post-operative period after breast lift surgery?
At the end of the operation, the patient is dressed in a special medical bra. The purpose of this bra is to hold the breasts in their new position and reduce edema and pain. It is recommended to wear this medical bra for 4-6 weeks. You can usually be discharged the next day after the operation. I do not use drains in breast lift surgeries, so we do not deal with drain removal. Minimal pain is expected in the early postoperative period. If the silicone implant is placed, the pain may be a little more, but these are all responsive to painkillers. You can take a shower on the 3rd day after the procedure. At the end of the first week, the limitation of arm movements decreases and a return to normal daily life is expected. Light exercises can be started at the end of 3 weeks, and all exercises usually can be started at the end of 6 weeks. Breasts that are higher and fuller than normal after the operation return to their normal position by the 3rd week. At this point, the edema is reduced to a minimal level. However, breast tissues take their last shape between 3-6 months. Since the absorbable sutures are used, it is not necessary to remove the stitches after the surgery.
What should be the expectation from breast lift surgery? Is 100% symmetry possible? Will the breast sag again?
It should not be forgotten that the aging process and gravity continue. In the following years, some sagging of the breast tissues is expected, but it is not possible to return to the pre-operative state. In addition, situations such as frequent weight gain and loss, pregnancy and breastfeeding can also cause sagging. Therefore, the most suitable candidates for this surgery are women who have reached their ideal weight and do not have a future pregnancy plan.
100% symmetry should not be expected. Because before the operation, there is a certain amount of asymmetry between both breasts of everyone. In addition, the structure of the rib cage and chest wall may also be asymmetrical. Pre-operative chest wall asymmetries will not improve after breast lift surgery. Although we use the most appropriate methods to correct the existing asymmetries in breast surgeries, it should not be forgotten that this asymmetry is quite normal and natural unless there is a noticeable difference when both sides are compared.
Will there be any scars after breast lift surgery?
In breast lift surgery; the scar is around the nipple, vertically extending down from the nipple, and sometimes in the inframammary fold (the fold under the breast) when deemed necessary. These scars never completely disappear, but after a certain time, the visibility of these scars will decrease considerably. The exception is wound healing disorders such as hypertrophic scars and keloids. When those situations are encountered, the relevant treatments are directed (See Scar Treatment Section). As a result, the scars that will occur in breast lift surgery depend on the technique and the current size. Considering all the mentioned factors, the most appropriate and least scarring method is selected. There is a very sensitive point here. It is also not reasonable to compromise on the desired breast shape and volume in order to reduce the amount of scars. It should not be forgotten that the feeling of happiness after the operation of lifted breasts usually becomes more dominant than the visibility of these scars. Therefore, an accurate patient-doctor communication is very important.
What are the complications of breast lift surgery?
Post-operative minimal pain is usually the most common problem. The process usually goes smoothly. In this surgery, the risk of not being able to breastfeed is not as high as feared. If breast reduction is performed, this rate increases slightly (See Breast Reduction Section). Breast lift surgery or silicone implants used for augmentation with this surgery do not increase the risk of breast cancer (See Breast Augmentation Section). Temporary loss of sensation may occur in the nipple areola complex after surgery, but this is not permanent. Another situation that can be encountered is wound healing problems ,which can be seen especially in smokers. In this situation, local wound care is usually sufficient, but it should not be forgotten that the best results will be obtained in non-smokers.
Summary
Breast lift surgery is one of the most effective and patient-satisfying operations that makes deformed and sagging breasts lifted and gives breasts a more aesthetic appearance. The minimal pain encountered after the operation is usually the biggest problem. It should be kept in mind that although its visibility decreases over time, the scars are permanent, it is not correct to expect 100% symmetry, and breast lift is a semi-permanent procedure, that is, the lifted breast form cannot be maintained for many years. Best regards.
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