A breast lift or mastopexy is a procedure that reshapes sagging breasts to give them a more youthful appearance. Many women are dissatisfied with the shape of their breasts, particularly after pregnancy or after significant weight loss. Breasts in some women take on a very droopy shape that is associated with old age. The nipple may drop below its desired position and the areola may be too large. There seems to be too much skin giving the breast a "rock in a sock" look. Breast lift surgery can return the volume of the breast to a higher position, reposition the nipple and make the areola smaller. Mastopexy makes the breast take on a more conical shape. Often breast lift surgery is combined with a breast implant in cases where there is not adequate breast volume and a great deal of loose skin. If the patient is comfortable with breast size when she is in a non padded bra then breast lift surgery alone will be enough. If the patient desires more volume than is presented in non padded bra, then a breast lift plus an implant may be the way to go. Combining breast lift with augmentation is quite complicated and requires a great deal of experience. Dr. Koenig successfully combines these two procedures when the patient requires this.

Consultation - Breast Lift Surgery
The breast lift patient must be well informed of scars that result from the mastopexy operation. Whereas breast augmentation leaves an unnoticeable scar, breast lift does have significant scarring. Some breast lift patients who only need a small lift can have a scar just around the nipple. More commonly the scar is around the nipple and extends to the bottom of the breast. Occasionally there is a scar also present under the breast. Fortunately breast lift scars improve over time, but are always present.

The Operation - Breast Lift
Mastopexy is usually done under general anesthesia or local anesthesia with sedation. The breast lift surgery takes approximately 2 hours and the patient is able to go home shortly after surgery is complete. The patient is placed in a post operative bra which is left on for approximately 3 weeks after breast lift surgery. There is relatively little pain after a breast lift. If breast lift surgery is combined with an implant the pain is similar to an implant alone. Dr. Koenig does not routinely use drains for a mastopexy, also all sutures are buried and do not require removal.

Recovery - Breast Lift Surgery
Most patients are quite comfortable after breast lift surgery and return to normal activity within 1-2 days. Bouncing activity like running or horseback riding should be avoided for 6 weeks which is when healing is complete. Other activities like walking, biking etc. that don't involve a bouncing motion can be started immediately. Breast lift scars usually take about a year to fade completely although some may take longer.

Complications- Breast Lift Surgery
Like any surgical procedure, breast lift surgery can have complications which include bleeding and infection. These complications are rare but do occur. In a small percentage of patients sensation to the nipples can be lost. This is usually temporary but may be permanent. Lifting of the breasts is like lifting of any tissue - gravity continues to have its effect and after over the years, recurrence may be a problem. This is more common in larger breasts and in those patients who combined the breast lift with an augmentation.

PRE-OPERATIVE INSTRUCTIONS:

BREAST LIFT SURGERY

THREE WEEKS BEFORE BREAST LIFT SURGERY:

• Laboratory and EKG (if they are required) must be done. If you are having your preoperative testing at a lab other than the one we suggested, you are responsible for having the written results of this testing arrive at our office one full week before your breast lift surgery (our fax number is 585-271-4786).
• BREAST LIFT SURGERY WILL NEED TO BE CANCELLED IF THERE IS ANY CHANCE THAT YOU ARE PREGNANT.
• All fees are due, including surgical, facility and anesthesia.

TWO WEEKS BEFORE BREAST LIFT SURGERY:

• Do not take any products containing aspirin, ibuprofen (Advil, Motrin), non-steroidal anti-inflammatory medication or Vitamin E. Tylenol is acceptable.
• Refrain from all nicotine products, including cigarettes, pipe tobacco, chew or Nicotine patch. Nicotine interferes with healthy circulation and may affect the result of your breast lift surgery. It also places you at higher risk of complication when receiving anesthesia.

ONE WEEK BEFORE BREAST LIFT SURGERY:

• Do not drink alcohol for 1 week before and after breast lift surgery.
• Please ensure that all laboratory tests and/or blood work has been completed by this time as ordered by the plastic surgeon/nurse practitioner. Our fax number is 585-271-4786.

THE DAY BEFORE BREAST LIFT SURGERY:

• Call 267-8200 to obtain your arrival time for the day of breast lift surgery.
• DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT (This includes water and gum chewing). Breast lift surgery may be cancelled if this is not followed. A fasting state is required in order to receive sedation for surgery. The only exception is medication, which we instruct you to take with a sip of water the morning of breast lift surgery.

DAY OF BREAST LIFT SURGERY:

• Go to suite 101 (Lindsay House Surgery Center).
• You may shower and shampoo the morning of surgery. Do not wear makeup, hair sprays or gels, or nail polish. You may leave acrylic nails on.
• Avoid clothing that must be pulled over the head. Please wear loose fitting clothing.
• Do not wear jewelry, including body jewelry or bring valuables to breast lift surgery.
• Do not use underarm deodorant.
• If you have your menstrual cycle, please wear a feminine napkin. Do not wear a tampon.

POST-OPERATIVE INSTRUCTIONS:

COMMON INSTRUCTIONS AFTER BREAST LIFT SURGERY:

• A responsible adult must provide transportation for you after breast lift surgery (public transportation is not permissible).
• A responsible adult must stay with you overnight and after your breast lift surgery until the morning following the procedure. If you are having several procedures, you may need or prefer assistance for 1-2 days following your procedure.
• Avoid making major decisions or participating in activities that require judgment for 24 hours after breast lift surgery.
• Do not drive for 24 hours after surgery or while you are taking pain medication. Do not drive for approximately 5-7 days after breast lift surgery.
• Avoid any activities that cause pain or discomfort.
• You are encouraged to walk around the house on the day of breast lift surgery and thereafter. This helps to prevent blood clots from developing in the legs.
• Move/pump your legs frequently while lying down. This also helps in preventing blood clots from developing. Wear the support stockings for at least 5 days after surgery or until fully active.
• Use your incentive spirometer 10 every hour while awake for 5 days after surgery or until fully active. This is necessary to prevent post operative pneumonia or atelactasis.
• Resume activities slowly. You may feel tired for the first few days. Avoid heavy lifting, bending, and straining for 3 weeks. You may resume all activity six weeks after breast lift surgery.
• Drink plenty of fluids (8-10 glasses/day) for the first week to keep well hydrated.
• If you have not urinated after 6 hours of being home from breast lift surgery, please contact our office.
• Expect to have some incisional discomfort for the first 24 hours after breast lift surgery. Take your pain medication before your pain becomes severe.
• Take all medications as instructed post operatively.
• You may resume all of your medications after one week from the time of breast lift surgery.
• Some bruising and swelling is normal. It is expected to take between 3-6 months to see your final results.
• Avoid direct sunlight to the incision for at least 1 year. Use a sunscreen with zinc oxide with an SPF of 20 or greater to help decrease the visibility of the scar.

POST OPERATIVE INSTRUCTIONS FOR BREAST LIFT SURGERY:

• You will have a support bra on after breast lift surgery; this will need to be worn continuously for the first 3 weeks. You will have a gauze pad/dressing over your breasts underneath the support bra. You should expect some drainage during the first 24 hours. You may change the gauze pads as needed. Keep the dressing dry. You may remove the dressing and shower after 5 days. There will be steri strips over your incision lines. It is okay to get them wet, you may gently pat dry with a towel or you can use a blow dryer (cool setting). Reapply your bra after showering. Do not remove the steri strips.

CALL OUR OFFICE IF YOU DEVELOP ANY OF THE FOLLOWING AFTER BREAST LIFT SURGERY:

• Fever of 101 degrees F or greater.
• Pain not relieved with pain medication.
• Swelling, redness, bleeding, and/or foul drainage from an incision site.
• Persistent nausea and/or vomiting.
• Any other concerns.

Click here for printer friendly pre-operative and post-operative breast lift instructions.