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Aesthetic Procedures: Breast

Aesthetic Procedures: Breast

Aesthetic Procedures: Breast

Breast Lift (Mastopexy)

Breast Lift-1
A breast lift can be performed on sagging breasts, a condition also known as ptosis. Breast ptosis can result from age, skin laxity, and loss of breast volume, commonly after stopping breast feeding. In some instances, women tend to have more droopy breasts. The severity of breast ptosis is graded according to the location of the nipple and breast tissue (gland) in accordance with the fold under your breast (inframammary fold).

⦁ Grade 1: Nipple at inframammary fold (IMF)
⦁ Grade 2: Nipple between IMF and lowest point of breast
⦁ Grade 3: Nipple at lowest point of breast
⦁ Pseudoptosis: Nipple above IMF but majority of breast tissue is below the IMF

How is a breast lift performed?

In mild cases of breast ptosis, placement of an implant can help with improving the position of the nipple as well as enhancing the breast. If the ptosis is more severe, this will require excision of excess breast skin combined with breast tissue rearrangement to help reduce the sagging and restore fullness to the breast.
 
There are various skin excision patterns, depending on how superiorly the nipple needs to be repositioned and amount of skin that needs to be removed. These can be around the nipple (periareolar), vertical-scar pattern, or upside-down T-scar pattern. Whichever the pattern, your incisions will be closed meticulously to minimize scarring. The areola will appear round, and its size will be matched to normal ideals.

The breast tissue, otherwise known as the parenchyma, is also mobilized, whilst maintaining its blood supply, to reinforce the breast lift and give it longevity. These cuts are made on the inside of the breast and you will not be able to see them. There is a low risk of reduced nipple sensation and most patients can breastfeed again after the procedure.

In some cases, the deflation in the breast leads to a large loss of volume together with sagging skin. This can be addressed in a breast augmentation-mastopexy procedure, where an implant is used to restore volume and the mastopexy is used to tighten the native breast envelope.
Breast Lift-2

 

What does the procedure involve?

Mastopexies are usually performed under deep sedation or general anaesthesia. Before the procedure, the eventual scar and shape will be discussed with you and markings are done. Surgical drains are usually not necessary. After the procedure, there may be mild pain which is usually well controlled with oral painkillers, and bruising which settles by 2 weeks. You will be asked to wear a support bra for the first 4 to 6 weeks after the procedure. You can get back to light exercise by 3 to 4 weeks after the procedure, and full exercise by 1 month after the procedure. The full result of your mastopexy will be seen at 3 months and beyond.

Risks and complications

Complications of mastopexy, though very rare, include:
  • Bleeding: If severe, it may require a second operation to evacuate/stop
  • Infection: Antibiotics will be given to you post-operatively to minimize this
  • Bad scarring: Scar management is instituted early to minimize this
  • Asymmetry/suboptimal aesthetic outcome: This is assessed at 3 months post-op and subsequent touch-up procedures can be considered
References
1. Hall-Findlay EJ. Pedicles in vertical breast reduction and mastopexy. Clin Plast Surg. 2002 Jul;29(3):379-91.
 
2. Doshier LJ, Eagan SL, Shock LA, Henry SL, Colbert SH, Puckett CL. The Subtleties of Success in Simultaneous Augmentation-Mastopexy. Plastic and Reconstructive Surgery. 2016 Sep;138(3):585–92.

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