Breast Lift

Who is offered a breast lift

A breast lift is for a patient with adequate volume whose mound has dropped with aging. Minimal droop can still look natural. The shape is compromised when breast tissue and the nipple fall below the inframammary crease, where the breast meets the tummy.

• The mound droops until it rests on the tummy.
• The nipple and areola sag and point down instead of straight ahead.
• The mound lateralizes into the armpit, and inner fullness is lost, especially when lying on the back.
• Medial cleavage is lost.
• Upper pole fullness is lost.
• Mound shape, size, and position can be asymmetric.
• Areola shape and position can be asymmetric.
• The areola diameter can be enlarged.

Newport Beach and Los Angeles are the cities named for that correction. Evaluation uses mound shape and position, medial and lateral pole lengths, and nipple and areola shape, size, and position. Excess skin is removed so the mounds can be proportionate and symmetric.

Volume, a reduction, and which pedicle

More volume means simultaneous placement of an implant, using a superior pedicle so the nipple and areola stay while the lower pole is opened for the implant. A modest volume reduction is directed to breast reduction. High definition liposuction is also named as a way to reduce volume. No liposuction protocol is given here.

The inferior pedicle is the choice when as much breast tissue as feasible should stay. The superior pedicle is reserved for larger breasts that need an implant, and it is also the pedicle named for that lower-pole opening.

How long a breast lift takes

One line gives 2 to 3 hours. A later line says breast lift surgery takes approximately 1 to 4 hours. Both ranges stay, and they are not averaged.

One line requires general anesthesia. A later line says general anesthesia is typical, especially for the anchor-shaped technique, while a concentric technique may use a local anesthetic plus intravenous sedation.

The setting is an outpatient surgical suite or a hospital operating room. On the account that requires general anesthesia, the room must be a hospital or an outpatient surgery center. An in-house office-based room is allowed less often, and only when a body such as AAAASF accredits it.

Which incision pattern is named

These are the patterns a breast lift is given. Concentric, also called peri-areolar mastopexy, is a ring around the areola for minimal sagging. Vertical runs around the areola and down the breast. One account assigns the vertical pattern and the anchor pattern to larger breasts with more extensive sagging. A later account assigns vertical mastopexy to minimal sagging, limited to the line from the areola downward.

The anchor pattern adds the inframammary fold. The inverted T Weiss pattern is that anchor-like scar: around the nipple, down the middle of the breast, and under the fold, for more extensive sagging. A separate line on vertical incision breast reductions says those scars surround the nipple, run down the breast, and do not continue under it. That line says reductions, and it stays.

Excess skin is removed and the nipple and areola move. One breast can be lifted more than the other. Areola size can be changed, and an implant can be added. Sutures are internal. Tape stays on the skin for four weeks. A supportive or exercise bra is worn for several weeks.

Sensation, scars, asymmetry, and nursing

Swelling numbs the breast and nipple for the first several weeks, also written as the first few weeks. It should last no longer than a few months, but it can last longer or become permanent. Causes named are nerve damage, reduced blood supply, and nerves that cannot be seen, may be injured, and can be cut if they cross the dissection.

Permanent loss of nipple sensation is also called unlikely, because only skin around the nipple is removed and the nerves need not be cut. That line does not cancel the permanent-loss account. Shape takes several months to settle, scars take several months to fade, and the numbness is called usually transient.

A hypertrophic scar is a thickened scar. Tightness follows how much redundant skin was removed. Redness is given a longer course, on average 3 to 6 months, and a later line says most redness dissipates by 3 to 6 months. Treatment is a steroid injection, laser therapy, and silicone pressure therapy. No dose is given.

Size, shape, and nipple position can remain uneven from asymmetry that was already there, or because the two sides heal differently. Symmetry should improve. Revision is reserved for an extreme mound or nipple difference.

The milk glands stay connected to the nipple, and the ducts are preserved, so breastfeeding is called typically unaffected and also generally unaffected. Patients are still told not to expect to breastfeed. The reason is that up to 50 percent of mothers who never had breast surgery cannot, also written as difficulty in 50 percent of cases. No study is linked.

Clots, collected fluid, infection, and the skin edge

Deep vein thrombosis may occur in the legs immediately after surgery. Leg veins clot, blood return from the legs can fall, and a clot that reaches the lungs is called pulmonary emboli and also a pulmonary embolus. It is rare and is called the leading cause of death following surgery. Pneumatic compression boots during surgery, and walking as soon as possible afterward, are the precautions.

A hematoma is blood pooling in a pocket early after surgery. Bacteria can grow there, including bacteria from an infection elsewhere in the body, and the result can be a breast infection and an open wound. Drains are not routine. They may be placed infrequently if the tissue is oozy, and then they stay 4 to 5 days.

A seroma is plasma after soft tissue is elevated and lymphatic vessels are disrupted. A low blood count, poor nutrition, and protein deficiency make it more likely. It can require several office aspirations, because the fluid can grow bacteria. Drains are also called very effective at preventing a seroma, and a seroma may appear if a drain comes out too early.

Infection can open the incision, and prolonged antibiotics are named. It is less likely if the patient does not smoke or quits for at least one month before surgery, and drains help by limiting a hematoma. It is most common with poorly controlled diabetes or smoking, and less likely if smoking stops one month before and for six weeks after. An implant used with the lift raises that chance.

The skin edge can die and the incision can open. Nicotine is said to clog the small skin vessels the edge needs. One account requires quitting for at least one month before surgery. The later account adds six weeks after surgery. The planning note says to quit for one month before breast reduction surgery and for six weeks afterward. Uncontrolled diabetes can slough the skin. An open wound needs prolonged dressing changes, and delayed healing can compromise the result.

Recovery clocks after a breast lift

Recovery is given as 2 to 3 weeks. If the job is not physical, work resumes at three weeks and all physical activity at six weeks.

If the job has no heavy physical stress, work can resume at one week. A strenuous job is restricted for four weeks. A physically rigorous job waits four months. For the first four weeks, lifting is no more than 5 lbs and arm work is reduced. Light duty can start within a few days.

Soreness lasts 2 to 4 days and is less when sagging is minimal and the incisions are fewer. Pain is greatest for the first 48 hours, then less each day, and pain medication relieves it. Antibiotics are also provided.

For the first day or two, upper body activity is limited, with rest and the head elevated so the arms are not used to get in and out of bed. A support bra with no underwire runs from two weeks up to one month, beside four weeks of external tape and a supportive or exercise bra for several weeks.

How long the shape is said to last

Without significant weight fluctuation and without pregnancy, the result is called a lifetime: sagging gone on the profile, extra skin gone, a perky youthful shape, and a better size match if the breasts were asymmetrical. A later line says many years, with patients extremely satisfied. Gravity still reduces firmness over time, while the contour stays better than before.

Age, the visit before surgery, and insurance

The operation can be done at any age, usually after the breasts are fully developed. Pregnancy and breastfeeding may still change size and shape. Many women have it before children and plan to treat later changes if they appear.

The first visit includes blood work. A mammogram is requested at 40 or older, or with a personal or family history of tenderness, lumps, or nipple discharge. From midnight before surgery there is no food or drink, so nothing is aspirated when anesthesia starts. Grogginess lasts several hours, so a ride is needed both ways and a caretaker stays the first night. Someone else lifts small children for the first couple of days.

Insurance coverage for a breast lift is, in most cases, a lifestyle choice rather than a medical necessity, so it is not covered. It is covered when the operation symmetrizes the opposite breast after reconstruction for breast cancer.

When an implant is added

A breast lift done with augmentation carries more complications: skin compromise, poor scars, and infection. Skin is removed and tightened, and the implant pushes outward on that skin. The combination is still called a mainstay. Postpartum mothers are said to deflate and sag together after nursing. The higher risk is meant to be discussed first.

Minimal to moderate sagging can be treated in one stage. Severe sagging is two stages: the lift first, then augmentation after the skin incisions heal, both finished within three months. A simultaneous case stays at minimal to moderate sagging and a medium implant of 100cc to 300cc. That pairing is what the page says avoids most of the added complications. No other volume is given.

The American Society of Plastic Surgeons says a breast lift, also known as mastopexy, raises the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour. It also says an enlarged areola can be reduced, which matches the enlarged areola on this page, along with removing excess skin and raising the breast. That source says size does not change much and the upper breast is not rounded out. This page instead lists lost upper pole fullness as a change to reverse, and it offers an implant for more volume or a reduction or high definition liposuction for less. Heredity is not a cause here. The hour ranges, the anesthetic split, the smoking clocks, the 50 percent nursing figure, the 100cc to 300cc limit, the three-month staging, the drain rules, and the 5 lb limit are not taken from that description.